The significance of pelvic and para-aortic lymphadenectomy in the operative treatment of ovarian cancer.
Since 1980, 95 of 320 patients with ovarian cancer of Stages I to IV have undergone pelvic lymphadenectomy. A further 57 patients underwent pelvic and para-aortic lymphadenectomy. In the last three years, 83% of patients with Stage III disease had a lymphadenectomy, and 34% had no gross residual tumour after surgery. This entailed bowel resection in 33% of cases. After cytoreduction and chemotherapy, actuarial 5-year survival in Stages I and II was 90%, and was just over 40% in Stage III. Patients with positive nodes had markedly poorer survival than did those with negative nodes. Three years after only pelvic lymphadenectomy, 36.7% of patients with Stage III disease had no clinical, radiological or biochemical evidence of disease. If the abdomen had been cleared of gross disease at surgery, 70% of the patients had no evidence of disease at 3 years. The therapeutic effect of lymphadenectomy is also reflected in the marked improvement in survival of all patients with Stage III ovarian cancer after the introduction of lymphadenectomy.
Burghardt
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E
Lahousen
M
M
Stettner
H
H
D002838:Chromaffin System / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010220:Para-Aortic Bodies / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000556:secondary / Q000601:surgery*; D011379:Prognosis