Abstract

Background and objectives: To identify the risk factors for para-aortic lymph node metastases in cases with presumed early stage ovarian cancer. Materials and methods: Between 2014 and 2019, 48 patients with apparent early stage ovarian cancer were submitted to surgery. In all cases, pelvic and para-aortic lymph node dissection was performed for staging purposes. Results: Among the 48 cases we identified nine cases with positive pelvic lymph nodes and 11 cases with positive para-aortic lymph nodes. The positivity of the retrieved lymph nodes was significantly correlated with the histopathological subtype represented by serous histology (p = 0.02), as well as with the degree of differentiation (p = 0.004). Conclusions: Patients with serous ovarian carcinomas in association with a poorer degree of differentiation are at risk of associated lymph node metastases even in presumed early stages of the disease. Therefore, lymph node dissection should be performed in such cases in order to provide adequate staging and tailoring of further treatment.

Highlights

  • Ovarian cancer represents a common malignancy affecting women worldwide that remains asymptomatic for a long period of time; most cases are diagnosed in advanced stages of the disease, when dissemination through peritoneal, hematogenous or lymphatic routes is already present [1]

  • Between 2014 and 2019, 48 patients with presumed early stage ovarian cancer were submitted to surgery with curative intent, the median age at the time of surgery being 43.4 years

  • In order to determine the risk factors for developing lymph node metastases in apparently early stage ovarian cancer, we conducted an univariate analysis in which we studied the influence of age, menopausal status, initial FIGO stage at diagnosis, laterality of the tumor, histology and degree of differentiation on the risk of developing node metastases

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Summary

Introduction

Ovarian cancer represents a common malignancy affecting women worldwide that remains asymptomatic for a long period of time; most cases are diagnosed in advanced stages of the disease, when dissemination through peritoneal, hematogenous or lymphatic routes is already present [1]. Up to 15% of these cases prove to have positive lymph nodes, which will significantly influence the long-term prognosis [2]; in the meantime, routine performance of extended pelvic and para-aortic lymph node dissection in presumed early stage ovarian cancer will. The aim of the current paper is to investigate the risk factors for developing para-aortic lymph node metastases in cases diagnosed with a presumed early stage of disease. To identify the risk factors for para-aortic lymph node metastases in cases with presumed early stage ovarian cancer. Conclusions: Patients with serous ovarian carcinomas in association with a poorer degree of differentiation are at risk of associated lymph node metastases even in presumed early stages of the disease. Lymph node dissection should be performed in such cases in order to provide adequate staging and tailoring of further treatment

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