Lymph node metastasis in grossly apparent stages I and II epithelial ovarian cancer.
OBJECTIVE
Incidence of lymph node metastasis is relatively high even in early-stage epithelial ovarian cancers (EOC). Lymphadenectomy is important in the surgical treatment of EOC; however, the exact role of lymphadenectomy in the management of EOC remains unclear. In this study, we evaluated lymph node metastasis in stages I and II EOC patients.


METHODS
Seventy-nine patients with stage I/II EOC underwent initial surgery, and 68 patients received adjuvant platinum and taxane chemotherapy after surgery at Keio University Hospital. The patients were evaluated with respect to age at diagnosis, clinical stage, histology, histological grade, and tumor laterality.


RESULTS
Of the 79 patients, 10 (12.7%) had lymph node metastasis. Of these, 4 (5.1%) had lymph node metastasis in paraaortic lymph node (PAN) only, 1 (1.3%) in pelvic lymph node (PLN) only, and 5 (6.3%) in both PAN and PLN. The incidence of serous-type lymph node metastasis in PAN, PAN + PLN, and total was higher than nonserous type (25% vs 1.5%, P < 0.0001; 25% vs 3.0%, P = 0.001; 50% vs 5.9%, P < 0.0001). However, there was no significant difference between lymph node status and T factor or histological grade. In 78% of patients (7/9), metastases in contralateral lymph nodes were present (contralateral, 2; bilateral, 5). There was no significant difference in progression-free survival between node-positive and node-negative groups (P = 0.47).


CONCLUSIONS
Based on diagnostic value, the result suggests that the role of lymphadenectomy might differ by histological type, as its therapeutic effect might be unclear. A multicenter analysis is essential for confirmation.
Nomura
Hiroyuki
H
Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan.
Tsuda
Hiroshi
H
Susumu
Nobuyuki
N
Fujii
Takuma
T
Banno
Kouji
K
Kataoka
Fumio
F
Tominaga
Eiichiro
E
Suzuki
Atsushi
A
Chiyoda
Tatsuyuki
T
Aoki
Daisuke
D
D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate