title: Lymph node metastasis in stages I and II ovarian cancer: a review.
abstract: OBJECTIVE
  The purpose of this review is to determine the incidence of lymph node metastases in clinical stages I and II ovarian cancer.
  
  
  METHODS
  Relevant articles were identified from MEDLINE and EMBASE, supplemented with citations from reference lists from the primary studies. Eligibility was evaluated by two authors. Included studies were prospective or retrospective cohort studies, which analyzed patients with clinical early stage EOC who underwent a complete pelvic and para-aortic lymphadenectomy as a part of a staging laparotomy.
  
  
  RESULTS
  Fourteen studies were included in the analysis. The mean incidence of lymph node metastases in clinical stages I-II EOC was 14.2% (range 6.1-29.6%), of which 7.1% only in the para-aortic region, 2.9% only in the pelvic region, and 4.3% both in the para-aortic and pelvic region. Grade 1 tumors had a mean incidence of lymph node metastases of 4.0%, grade 2 tumors 16.5.8% and grade 3 tumors 20.0%. According to histological subtype, the highest incidence of lymph node metastases was found in the serous subtype (23.3%), the lowest in the mucinous subtype (2.6%). In unilateral tumors, pelvic lymph node metastases were found in 9.7% on both sides, 8.3% only at the ipsilateral side, and in 3.5% only at the contralateral side.
  
  
  CONCLUSIONS
  The incidence of lymph node metastases in clinical early stage EOC is considerable. Based on the scarce literature data, omitting a systematic lymphadenectomy can only be considered in grade I mucinous tumors.
authors: Maastricht University Medical Centre, Department of Obstetrics and Gynecology, Maastricht, The Netherlands.
authors: M
authors: M
authors: Kleppe
authors: T
authors: T
authors: Wang
authors: T
authors: T
authors: Van Gorp
authors: B F M
authors: BF
authors: Slangen
authors: A J
authors: AJ
authors: Kruse
authors: R F P M
authors: RF
authors: Kruitwagen
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000473:pathology*