Prognostic Significance of Systematic Lymphadenectomy as Part of Primary Debulking Surgery in Patients with Ovarian Cancer

Abstract

Background: worldwide, ovarian cancer is diagnosed in more than 200,000 women yearly and accounts for over 125,000 deaths. Unfortunately, about 70% of cases are diagnosed in an advanced-stage with evidence of upper abdominal spread in approximately half of these. Aim of the Work: was to review the surgical management of female patients with ovarian cancer including intraperitoneal complete cytoreduction and systematic lymphadenectomy to show prognosis, post operative morbidities, recurrence and follow up. Patients and Methods: this study was conducted at Al-Azhar university hospitals and El Agousa police hospital – Ministry of interior - on 20 female patients who suffered from different stages of epithelial ovarian cancer with stage II, none bulky stage III, and only One patient with bilateral ovarian cancer stage Ic. Results: This is study conducted on female patients with ovarian cancer the mean age of the studied patients was 51.35 years ranging from 37-64 years. 55% of patients represented with abdominal distension, 50% had abdominal pain, 40% abdominal discomfort,15% had abnormal bleeding ,65% had nonspecific GIT manifestation ,20% had urinary symptoms and 10% had back pain. Conclusion: Although the relationship between the retroperitoneal spread of lymph nodes and patient prognosis has been demonstrated in several studies. lymphadenectomy, as a routine treatment procedure in ovarian cancer, remains controversial. Moreover, systematic lymphadenectomy often prolongs operation times, which may result in additional surgical complications such as lymphocele, lymphatic obstruction, lymphocysts and lymphedema, however these complications may be alleviated, and better outcome occurred by proper intra operative and post operative management by expert gynecological oncologist involvement and leveraging adequate instruments, which can eventually improve survival.