The Effect of Para Aortic Lymph Node Dissection in Staging and Complete Cytoreductive Surgery of Ovarian Cancer

Abstract

Objective: Lymphatic spread is a common feature of ovarian cancer both in early and advanced stages of the disease. There is also a controversial problem of the impact of para-aortic lymph node dissection between gynecologist oncologist experts. The aim of this study is evaluating the effect of Para aortic Lymph node dissection in ovarian cancer patients. Methods: This descriptive cross-sectional study was performed on 100 ovarian cancer patients admitted in department of gynecology oncology of Ghaem hospital, Mashhad University of Medical Sciences, Iran, from November 2013 - 2014. All patients underwent surgical staging surgery and optimal debulking surgery as possible. In addition, concurrent systematic pelvic and para-aortic lymphadenectomy up to the level of inferior mesenteric artery was performed. Results: A total of 100 patients were studied. The mean age was 47 years (SD = 13). In 73 patients optimal cytoreductive surgery was done with para aortic lymphadenectomy. 53 cases (72.6%) were in primary cytoreductive surgery and 20 cases (27.3%) in interval debulking surgery groups. Positive paraaortic lymph node in the first group was 6 cases (11.3) and in the second group was 2 cases (10%). 27 patients were in apparent stage I and 46 patients were in stage II-III-IV of disease. We found positive paraaortic lymph node in 11% of total patients. We found positive paraaortic lymph node without positive pelvic lymph node in two patients. Conclusions: Lymph node dissection will produce a significant benefit in accurate and complete surgical staging; it will reduce residual disease and then progression-free survival.