Should pelvic and para-aortic lymphadenectomy be different depending on histological subtype in epithelial ovarian cancer?
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.
Roger
Natacha
N
Service de Chirurgie, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805, Villejuif, France.
Zafrani
Yaelle
Y
Uzan
Catherine
C
Gouy
Sebastien
S
Rey
Annie
A
Pautier
Patricia
P
Lhommé
Catherine
C
Duvillard
Pierre
P
Castaigne
Damienne
D
Morice
Philippe
P
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