Anatomy of pelvic and para-aortic nodal spread in patients with primary fallopian tube carcinoma.
BACKGROUND
To describe characteristics of patients with nodal spread and the anatomy of pelvic and para-aortic node involvement in primary fallopian tube carcinoma.


METHODS
Between 1985 and 2003, 19 women with primary fallopian tube carcinoma underwent systematic bilateral pelvic and para-aortic lymphadenectomy up to the level of the left renal vein. Initial lymphadenectomy (without chemotherapy) was performed in 6 patients and in 13 patients lymphadenectomies were performed after chemotherapy at the time of second-look operation.


RESULTS
Nine patients had nodal involvement: four in the pelvic area and eight in the para-aortic nodes. Two, one, and six patients had stages I, II, or III disease, respectively. When para-aortic nodes were involved, the left para-aortic chain above the level of the inferior mesenteric artery was the site most frequently involved (six patients).


CONCLUSIONS
In patients with primary tubal carcinoma, the left para-aortic chain above the level of the inferior mesenteric artery is the most frequently involved. Lymphadenectomy should involve all pelvic and para-aortic chains up to the level of the left renal vein, even in patients with stage I disease.
Deffieux
Xavier
X
Department of Gynecological Surgery, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France.
Morice
Philippe
P
Thoury
Anne
A
Camatte
Sophie
S
Duvillard
Pierre
P
Castaigne
Damienne
D
D000328:Adult; D000368:Aged; D001012:Aorta, Abdominal; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery; D005185:Fallopian Tube Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010388:Pelvis