title: Pathological diagnosis and cytoreduction of cardiophrenic lymph node and pleural metastasis in ovarian cancer patients using video-assisted thoracic surgery.
abstract: BACKGROUND
  The aim of this study was to assess the benefit of video-assisted thoracic surgery (VATS) in pathological diagnosis and intrathoracic cytoreduction of cardiophrenic lymph node (CPLN) and pleural metastasis on computed tomography (CT) in patients with ovarian cancer.
  
  
  METHODS
  We reviewed a database of ovarian cancer patients who underwent VATS from June 2007 to November 2008. The criterion for suspicion of malignancy on CT was either a CPLN with short-axis dimension >5 mm or multinodular pleural thickening. Seven patients with primary ovarian cancer and five patients with recurrent ovarian cancer were identified and evaluated.
  
  
  RESULTS
  Twelve patients met the criterion for suspicious malignancy on CT, with CPLN metastasis and pleural metastasis in nine and five patients, respectively. CPLN metastasis was identified in two of four patients with primary ovarian cancer and in all five patients with recurrent ovarian cancer who had CPLN >5 mm on CT. Pleural metastasis was identified in three of five patients with suspicious pleural metastasis and in one of seven patients without suspicious pleural metastasis on preoperative CT. The median operation time for VATS was 65 min and estimated blood loss was less than 20 ml in all cases. All visible intrathoracic diseases were completely resected without major complications, and VATS did not delay planned treatment.
  
  
  CONCLUSIONS
  VATS enables the accurate pathological diagnosis and intrathoracic resection of pleural and CPLN metastasis in patients with ovarian cancer with acceptable morbidity. Further studies are needed to confirm the impact of VATS on survival in patients with ovarian cancer.
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea. mclim@ncc.re.kr
authors.forename: Myong Cheol
authors.initials: MC
authors.lastname: Lim
authors.forename: Hyun-Sung
authors.initials: HS
authors.lastname: Lee
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Jung
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Sang-Soo
authors.initials: SS
authors.lastname: Seo
authors.forename: Sang-Yoon
authors.initials: SY
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology*; D010997:Pleural Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D012042:Registries; D020775:Thoracic Surgery, Video-Assisted