title: Should pelvic and para-aortic lymphadenectomy be different depending on histological subtype in epithelial ovarian cancer?
abstract: BACKGROUND
  The aim of this study was to determine the influence of the different histological subtypes (serous versus non-serous) on the location of nodal metastases in patients undergoing pelvic and para-aortic lymphadenectomies during the initial management of epithelial ovarian tumors.
  
  
  METHODS
  We carried out a retrospective analysis of data concerning patients fulfilling the following inclusion criteria: (1) an epithelial ovarian tumor; (2) a complete pelvic and bilateral para-aortic lymphadenectomy up to the level of the left renal vein; (3) surgical procedures including lymphadenectomies performed before adjuvant chemotherapy; and (4) a description of the distribution of positive nodes removed between pelvic and para-aortic areas. Patients were classified into two groups according to the histological subtypes: serous (group 1) and non-serous (group 2) tumors.
  
  
  RESULTS
  Of patients treated between 1989 and 2005, 148 fulfilled the inclusion criteria: 73 had a serous tumor and 75 a non-serous tumor. Positive nodes were observed in 70 (47%) patients-47 (64%) in group 1 and 23 (31%) in group 2 (P < 0.05). But the distribution of involved nodes between pelvic and para-aortic areas in patients with positive nodes was not statistically different between the two groups. In both groups, the most common site for positive nodes in the para-aortic area was the left para-aortic group: 74% in group 1 and 61% in group 2 (NS).
  
  
  CONCLUSIONS
  This series suggests that the histological subtype has no impact on the distribution of positive nodes in pelvic and para-aortic areas in patients with epithelial ovarian tumors.
authors.affiliation: Service de Chirurgie, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805, Villejuif, France.
authors.forename: Natacha
authors.initials: N
authors.lastname: Roger
authors.forename: Yaelle
authors.initials: Y
authors.lastname: Zafrani
authors.forename: Catherine
authors.initials: C
authors.lastname: Uzan
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gouy
authors.forename: Annie
authors.initials: A
authors.lastname: Rey
authors.forename: Patricia
authors.initials: P
authors.lastname: Pautier
authors.forename: Catherine
authors.initials: C
authors.lastname: Lhommé
authors.forename: Pierre
authors.initials: P
authors.lastname: Duvillard
authors.forename: Damienne
authors.initials: D
authors.lastname: Castaigne
authors.forename: Philippe
authors.initials: P
authors.lastname: Morice
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000556:secondary / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D001011:Aorta; D018269:Carcinoma, Endometrioid / Q000556:secondary / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018284:Cystadenocarcinoma, Serous / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010220:Para-Aortic Bodies; D010388:Pelvis; D011379:Prognosis; D012189:Retrospective Studies