The Risk of Para-Aortic Lymph Node Metastases in Apparent Early Stage Ovarian Cancer

Abstract

Background and objectives: To identify the risk factors for para-aortic lymph node metastases in cases with presumed early stage ovarian cancer. Materials and methods: Between 2014 and 2019, 48 patients with apparent early stage ovarian cancer were submitted to surgery. In all cases, pelvic and para-aortic lymph node dissection was performed for staging purposes. Results: Among the 48 cases we identified nine cases with positive pelvic lymph nodes and 11 cases with positive para-aortic lymph nodes. The positivity of the retrieved lymph nodes was significantly correlated with the histopathological subtype represented by serous histology (p = 0.02), as well as with the degree of differentiation (p = 0.004). Conclusions: Patients with serous ovarian carcinomas in association with a poorer degree of differentiation are at risk of associated lymph node metastases even in presumed early stages of the disease. Therefore, lymph node dissection should be performed in such cases in order to provide adequate staging and tailoring of further treatment.

The attributive value of comprehensive surgical staging in clinically early-stage epithelial ovarian carcinoma: A systematic review and meta-analysis

“…A2). Four articles had an overall score of 5 or lower (i.e., high risk of bias) and were excluded from further analysis [32][33][34][35]. The predominant quality issues within the included studies were unexplained missing or unreported data, lack of reproducible method description, or unspecified study population.…”

The attributive value of comprehensive surgical staging in clinically early-stage epithelial ovarian carcinoma: a systematic review and meta-analysis.

“…Quality assessment yielded one article 11 within an overall judgment of 8 points (i.e., low risk of bias) and 22 studies 7,8,12-31 with 6-7 points (i.e., moderate risk of bias) (see Appendix Figure S2). Four articles had an overall score of 5 or lower (i.e., high risk of bias) and were excluded from further analysis [32][33][34][35] . The predominant quality issues within the included studies were unexplained missing or unreported data, lack of reproducible method description, or unspecified study population.…”

EM-transcriptomic signature predicts drug response in advanced stages of high-grade serous ovarian carcinoma based on ascites-derived primary cultures

“…Moreover, growth factors and hormones are secreted onto the ovarian surface to induce EMT via phosphoinositide-3-kinase/Akt (PI3K/AKT) and mitogen-activated protein kinase/extracellular signal-regulated kinase (MEK/ERK) signaling pathways ( Wong and Leung, 2007 ; Gao et al, 2014 ; Dean et al, 2017 ). In the metastatic stage, cancer cells are released from the primary tumor directly into the peritoneal cavity and survive either as single cells or spheroids in the ascites fluid, causing the formation of peritoneal nodules (peritoneal carcinomatosis) and also metastases to distant organs ( Tan et al, 2006 ; Shield et al, 2009 ; Lengyel, 2010 ; Bacalbasa et al, 2020b ). EMT upregulates α5β1 integrin, which mediates spheroid attachment to the secondary site ( Al Habyan et al, 2018 ; Li et al, 2020 ).…”