gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Localisation and prediction of lymph node metastases in ovarian cancer

Meeting Abstract

  • corresponding author presenting/speaker Philipp Harter - Klinik für Gynäkologie & Gynäkologische Onkologie, HSK, Wiesbaden, Deutschland
  • Karsten Gnauert - Klinik für Gynäkologie & Gynäkologische Onkologie, HSK, Wiesbaden
  • Bernd Neugebauer - Institut für Pathologie, HSK, Wiesbaden
  • Rita Hils - Klinik für Gynäkologie & Gynäkologische Onkologie, HSK, Wiesbaden
  • Christine Buhrmann - Klinik für Gynäkologie & Gynäkologische Onkologie, HSK, Wiesbaden
  • Alexander Traut - Klinik für Gynäkologie & Gynäkologische Onkologie, HSK, Wiesbaden
  • Annette Fisseler-Eckhoff - Institut für Pathologie, HSK, Wiesbaden
  • Andreas du Bois - Klinik für Gynäkologie & Gynäkologische Onkologie, HSK, Wiesbaden

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO361

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dkk2006/06dkk471.shtml

Veröffentlicht: 20. März 2006

© 2006 Harter et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Para-aortic lymphadenectomy is part of staging in early ovarian cancer and part of surgical therapy in advanced ovarian cancer. However, compliance to guidelines outside specialized centers is poor and one of the most frequently missed procedures is para-aortic lymphadenectomy even if pelvic lymphadenectomy is performed. We analyzed intraoperative palpation and pelvic lymphadenectomy as predictors for para-aortic lymph node involvement, in order to evaluate if there might be a subpopulation of patients in whom para-aortic lymphadenectomy could be omitted based on intraoperative findings.

Methods: Retrospective analysis of our hospital data base (08/99 – 08/05) of patients with epithelial invasive ovarian cancer who had systematic pelvic and para-aortic lymphadenectomy during primary surgery.

Results: 143 patients underwent systematic pelvic and para-aortic lymphadenectomy. Fifty-three patients had early ovarian cancer, macroscopically limited to the pelvis (pT1-3a, M0) and 90 patients had advanced disease (pT3b/c, M0/1). Sixty nine patients (48%) had intraoperative suspicious lymph nodes and 77 patients (54%) had histological lymph node metastases. Thirteen percent of the patients with early ovarian cancer and 80% with advanced disease had lymph node metastases. The sensitivity of palpation was 66%, specifity 68%, PPV 65% and NPV 69%. None of the patients with early ovarian cancer had only pelvic lymph node metastases. Seventeen percent of the patients with advanced disease had only positive paraaortic lymph nodes. The highest frequency of positive lymph nodes was found in the upper left para-aortic region close to the renal vein (30% of all patients) and between vena cava inferior and abdominal aorta (37%).

Conclusion: Neither clinical assessment nor pelvic lymphadenectomy could reliably predict pathological status of para-aortic lymph nodes. Pelvic and paraaortic lymphadenectomy is necessary for staging patients with early ovarian cancer. Patients with ovarian cancer in whom systematic pelvic and para-aortic lymphadenectomy might be indicated should attend a center capable of performing this procedure.