title: Relevance of pelvic and para-aortic node metastases in early-stage ovarian cancer.
abstract: OBJECTIVE
  To delineate the relevance of pelvic and para-aortic node involvement in early-stage ovarian cancer.
  
  
  METHODS
  Data on 75 consecutive patients with primary stage T1 and 2 ovarian cancer treated at the Department of Gynecology, University Tuebingen, Germany were retrospectively analyzed. All patients underwent stage-related surgery with pelvic and para-aortic lymphadenectomy and adjuvant platinum-based chemotherapy (except pT1aG1). Median follow up was 53.5 months. Clinico-pathological parameters and the distribution pattern of node metastases were evaluated. Statistical analyses were performed using PASW.
  
  
  RESULTS
  Lymph node metastases were detectable in T1 and T2 in 6 (8%) of 75 patients. Three patients (4%) had lymph node metastases in the pelvic nodes only, 2 patients (2.7%) in the para-aortic nodes only; 1 patient (1.3%) both in the pelvic and para-aortic nodes. On multivariate analysis, histological grade 1/ 2 and 3 tumors, serous and endometrioid histology were independent predictors for node metastases, respectively. The risk of relapse was significantly higher with detection of node metastases (p=0.004).
  
  
  CONCLUSIONS
  A systematic lymphadenectomy in early-stage ovarian cancer leads to an upstaging in a few patients after detection of node metastases even in pelvic or para-aortic nodes, especially in patients with grade 3 tumours and serous cancers. Pelvic and para-aortic lymphadenectomy may detect node involvement in early-stage ovarian cancer and might be helpful in correct staging.
authors.affiliation: Department of Gynecology, University Tübingen, Tübingen, Germany cornelia.bachmann@med.uni-tuebingen.de.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Bachmann
authors.affiliation: Department of Gynecology, University Tübingen, Tübingen, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Krämer
authors.affiliation: Department of Gynecology, University Tübingen, Tübingen, Germany.
authors.forename: Sara Y
authors.initials: SY
authors.lastname: Brucker
authors.affiliation: Department of Pathology, University Tübingen, Tübingen, Germany.
authors.forename: Anette
authors.initials: A
authors.lastname: Stäbler
authors.affiliation: Department of Pathology, University Tübingen, Tübingen, Germany.
authors.forename: Falko
authors.initials: F
authors.lastname: Fend
authors.affiliation: Department of Gynecology, University Tübingen, Tübingen, Germany.
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.affiliation: Department of Gynecology, University Tübingen, Tübingen, Germany.
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Grischke
authors.affiliation: Department of Gynecology, University Tübingen, Tübingen, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Rothmund
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000556:secondary / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018284:Cystadenocarcinoma, Serous / Q000556:secondary / Q000601:surgery; D016889:Endometrial Neoplasms / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010220:Para-Aortic Bodies / Q000473:pathology*; D010386:Pelvic Neoplasms / Q000556:secondary* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies
keywords: Node metastases; early ovarian cancer; histology; lymphadenectomy; prognosis