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10.1245/s10434-007-9639-6
Annals of Surgical Oncology 15:333-338 (2008)
© 2008 Society of Surgical Oncology
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Original Article

Should Pelvic and Para-aortic Lymphadenectomy Be Different Depending on Histological Subtype in Epithelial Ovarian Cancer?

Natacha Roger, MD1, Yaelle Zafrani, MD1, Catherine Uzan, MD1, Sebastien Gouy, MD1, Annie Rey, MD1, Patricia Pautier, MD1, Catherine Lhommé, MD1, Pierre Duvillard, MD1, Damienne Castaigne, MD1 and Philippe Morice, MD1,2

1 Service de Chirurgie, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805, Villejuif, France
2 Universite Paris-Sud, Paris 11, France

Correspondence: Address correspondence and reprint requests to: Philippe Morice, MD; E-mail: morice{at}igr.fr

Background: The aim of this study was to determine the influence of the different histological subtypes (serous versus non-serous) on the location of nodal metastases in patients undergoing pelvic and para-aortic lymphadenectomies during the initial management of epithelial ovarian tumors.

Methods: We carried out a retrospective analysis of data concerning patients fulfilling the following inclusion criteria: (1) an epithelial ovarian tumor; (2) a complete pelvic and bilateral para-aortic lymphadenectomy up to the level of the left renal vein; (3) surgical procedures including lymphadenectomies performed before adjuvant chemotherapy; and (4) a description of the distribution of positive nodes removed between pelvic and para-aortic areas. Patients were classified into two groups according to the histological subtypes: serous (group 1) and non-serous (group 2) tumors.

Results: Of patients treated between 1989 and 2005, 148 fulfilled the inclusion criteria: 73 had a serous tumor and 75 a non-serous tumor. Positive nodes were observed in 70 (47%) patients—47 (64%) in group 1 and 23 (31%) in group 2 (P < 0.05). But the distribution of involved nodes between pelvic and para-aortic areas in patients with positive nodes was not statistically different between the two groups. In both groups, the most common site for positive nodes in the para-aortic area was the left para-aortic group: 74% in group 1 and 61% in group 2 (NS).

Conclusions: This series suggests that the histological subtype has no impact on the distribution of positive nodes in pelvic and para-aortic areas in patients with epithelial ovarian tumors.

Key Words: Ovarian cancer • Lymph nodes • Lymphadenectomy • Para-aortic nodes • Histological subtypes






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