Early ovarian cancer: what is the staging impact of retroperitoneal node sampling?
BACKGROUND
Comprehensive surgical staging of apparent early-stage epithelial ovarian cancer includes peritoneal washings, biopsies, and retroperitoneal lymph node dissection. Unresolved is the relative frequency or importance of the lymph node dissection.


OBJECTIVE
(1) To determine the site(s) of microscopic metastatic disease in women undergoing a comprehensive staging for apparent early-stage cancer of the ovary; (2) to identify those women with metastases in the retroperitoneal lymph nodes alone.


METHODS
Between 1985 and 2000, we reviewed all records of women at cancer centres in Winnipeg, Ottawa, and Saskatoon who had undergone a "staging laparotomy" for an apparent early-stage IA epithelial cancer of the ovary. Histology, tumour grade, initial and final surgical stage, and the site(s) of metastatic disease were recorded for all cases.


RESULTS
Forty-three of the 128 women (34%) had a final surgical stage of II or III. Sixteen women had positive pelvic biopsies, while 19 had microscopic upper abdominal disease. Eight women had positive retroperitoneal nodes, and in only 2 of these women, disease was found in the retroperitoneal nodes alone. In the 8 women with nodal disease, 5 had grade 3 tumours and 6 had serous histology tumours.


CONCLUSIONS
Comprehensive staging is important to identify women with metastatic disease. Solitary nodal metastases are predominantly found in grade 3 and serous tumours.
Faught
W
W
Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, University of Alberta, Edmonton, Canada.
Le
T
T
Fung Kee Fung
M
M
Krepart
G
G
Lotocki
R
R
Heywood
M
M
D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology / Q000556:secondary; D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology / Q000556:secondary; D002170:Canada / Q000453:epidemiology; D018269:Carcinoma, Endometrioid / Q000453:epidemiology / Q000556:secondary; D018283:Cystadenocarcinoma, Papillary / Q000453:epidemiology / Q000556:secondary; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008499:Medical Records; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000473:pathology; D012186:Retroperitoneal Neoplasms / Q000453:epidemiology* / Q000556:secondary; D012189:Retrospective Studies