514 Pelvic and Para-Aortic Lymphadenectomy in Early Stage Ovarian Cancer At The Philippine General Hospital

Introduction: Ovarian cancer continues to have low survival rates. Studies show the need for thorough surgical staging. Objectives: to determine the incidence of lymph node metastases in early stage ovarian cancer; to determine the safety of complete lymphadenectomy. Methodology: Patients who were diagnosed pre-operatively to have early stage (stage I-II) ovarian cancer and who were referred to the Gynecologic Oncology section of the UP-PGH from August 1999 to May 2001 were included in the study. Aside from the definitive surgical procedure, they underwent either complete lymph node dissection, which involved removal of both pelvic and para-aortic lymph nodes or, bilateral lymph node dissection, which involves removal of only the pelvic lymph nodes. These were assessed for the presence of metastases and correlated with the clinical and morphological feature of cases positive for metastases. Results: Ninety-nine patients with mean age 39.8 years. Six patients were upstaged to stage IIIC, 1 of 67 in stage IA, 1 of 6 in stage IB, 3 of 19 in stage IC, and 1 of 3 in stage IIB. No surgical mortality. Mean operative time for complete lymphadenectomy was 37.6 minutes. Average blood loss was 117.4 ml. The only complication was 1 vena caval injury. Conclusion: Lymphadenectomy is safe and is essential before definitive treatment in early stage ovarian cancer.