title: Prevalence and distribution pattern of nodal metastases in advanced ovarian cancer.
abstract: The objective of this study was to examine the relevance of pelvic and para-aortic lymph node involvement and the tumour characteristics affecting nodal metastases and survival in primary advanced ovarian cancer. A total of 130 consecutive patients were retrospectively investigated. All the patients received stage-related surgery with pelvic and para-aortic lymphadenectomy. The median follow-up was 53.5 months. The clinicopathological parameters and distribution pattern of nodal metastases were evaluated. Lymph node metastases were detectable in 74.62% of the cases. Overall, both pelvic and para-aortic nodes were affected in 35.9% of the patients, whereas 13.3% had metastases only in the pelvic and 13.3% only in the para-aortic lymph nodes. Histological grade 1/2 and 3, serous and endometrioid histology were independent predictors of nodal metastasis. Serous and endometrioid cancers have shown a predilection for metastasis to the pelvic lymph nodes alone, both to the pelvic and the para-aortic nodes, or the para-aortic nodes alone. Overall survival was significantly positively affected by serous histology with positive nodes (P=0.043). It is crucial to investigate the risk factors and metastatic patterns of such patients in a multicenter analysis to evaluate individual subgroups. Prospective studies are required to investigate the prognostic effect of lymphadenectomy in advanced ovarian cancer and its association with histology and distribution pattern of nodal metastasis.
authors.affiliation: Department of Gynecology, University of Tübingen, D-72070 Tübingen, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Bachmann
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital of Tübingen, D-72076 Tübingen, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Bachmann
authors.affiliation: Department of Gynecology, University of Tübingen, D-72070 Tübingen, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kraemer
authors.affiliation: Department of Gynecology, University of Tübingen, D-72070 Tübingen, Germany.
authors.forename: Sara Yvonne
authors.initials: SY
authors.lastname: Brucker
authors.affiliation: Department of Pathology, University of Tübingen, D-72076 Tübingen, Germany.
authors.forename: Anette
authors.initials: A
authors.lastname: Staebler
authors.affiliation: Department of Pathology, University of Tübingen, D-72076 Tübingen, Germany.
authors.forename: Falko
authors.initials: F
authors.lastname: Fend
authors.affiliation: Department of Gynecology, University of Tübingen, D-72070 Tübingen, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Rothmund
authors.affiliation: Department of Gynecology, University of Tübingen, D-72070 Tübingen, Germany.
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
keywords: advanced ovarian cancer; histology; lymphadenectomy; nodal involvement; tumour characteristics