title: Incidence of lymph node metastases in clinical early-stage mucinous and seromucinous ovarian carcinoma: a retrospective cohort study.
abstract: OBJECTIVE
  The use of lymph node sampling during staging procedures in clinical early-stage mucinous ovarian carcinoma (MOC) is an ongoing matter of debate. Furthermore, the incidence of lymph node metastases (LNM) in MOC in relation to tumour grade (G) is unknown. We aimed to determine the incidence of LNM in clinical early-stage MOC per tumour grade.
  
  
  METHODS
  Retrospective study with data from the Dutch Pathology Registry (PALGA).
  
  
  METHODS
  The Netherlands, 2002-2012.
  
  
  METHODS
  Patients with MOC.
  
  
  METHODS
  Histology reports on patients with MOC diagnosed in the Netherlands between 2002 and 2012 were obtained from PALGA. Reports were reviewed for diagnosis, tumour grade and presence of LNM. Clinical data, surgery reports and radiology reports of patients with LNM were retrieved from hospital files.
  
  
  METHODS
  Incidence of LNM, disease-free survival (DFS).
  
  
  RESULTS
  Of 915 patients with MOC, 426 underwent lymph node sampling. Cytoreductive surgery was performed in 267 patients. The other 222 patients received staging without lymph node sampling. In eight of 426 patients, LNM were discovered by sampling. In four of 190 (2.1%) patients with G1 MOC, LNM were present, compared with one of 115 (0.9%) patients with G2 MOC and three of 22 (13.6%) patients with G3 MOC. Tumour grade was not specified in 99 patients. Patients with clinical early-stage MOC had no DFS benefit from lymph node sampling.
  
  
  CONCLUSIONS
  LNM are rare in early-stage G1 and G2 MOC without clinical suspicion of LNM. Therefore, lymph node sampling can be omitted in these patients.
  
  
  CONCLUSIONS
  Lymph node sampling can be omitted in clinical early-stage G1 and G2 mucinous ovarian cancer.
authors.affiliation: Department of Gynaecological Oncology, Centre for Gynaecological Oncology Amsterdam, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Joam
authors.initials: J
authors.lastname: van Baal
authors.affiliation: Division of Diagnostic Oncology & Molecular Pathology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: K K
authors.initials: KK
authors.lastname: Van de Vijver
authors.affiliation: Division of Immunology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: S B
authors.initials: SB
authors.lastname: Coffelt
authors.affiliation: Department of Biometrics, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: V
authors.initials: V
authors.lastname: van der Noort
authors.affiliation: Department of Gynaecological Oncology, Centre for Gynaecological Oncology Amsterdam, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: W J
authors.initials: WJ
authors.lastname: van Driel
authors.affiliation: Department of Gynaecological Oncology, Centre for Gynaecological Oncology Amsterdam, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: G G
authors.initials: GG
authors.lastname: Kenter
authors.affiliation: Department of Gynaecological Oncology, Centre for Gynaecological Oncology Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: M R
authors.initials: MR
authors.lastname: Buist
authors.affiliation: Department of Gynaecological Oncology, Centre for Gynaecological Oncology Amsterdam, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Car
authors.initials: C
authors.lastname: Lok
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology*; D012042:Registries; D012189:Retrospective Studies
keywords: Lymph node metastases; lymph node sampling; mucinous ovarian carcinoma; staging procedure; tumour grade