The investigation of the factors affecting retroperitoneal lymph node metastasis in stage IIIC and IV epithelial ovarian cancer

Introduction The appropriate management of advanced ovarian cancer has been controversial in recent years. Lymphatic node involvement is known one of the most important prognostic factors in epithelial ovarian carcinomas. On the other hand in patients with advanced ovarian cancer involving the upper abdomen (with/without lymph node involvement) the evaluation of pelvic and para-aortic lymph nodes does not contribute to the staging and more importantly it does not improve overall-survival. Materials and methods One hundred three patients underwent systematic pelvic and para-aortic lymphadenectomy in our clinic. Fifty-three patients with FIGO stage IIIC and IV epithelial ovarian tumor were included in the study. The numbers of positive lymph nodes in each patient were compared with the preoperative CA125 values, positivity/negativity of peritoneal washings and tumor types. Also we compared the patients with positive lymph nodes with patients with negative lymph nodes and investigate differences in CA125 levels, histological types, and cytology. Results No significant difference was observed between the patients’ preoperative CA125 values and the number of positive lymph nodes. A significant relation was not determined between the positivity or negativity of peritoneal washings and the number of positive lymph nodes. As a number of positive lymph nodes were compared with the tumor types a significant difference was not observed. On the other hand, statistically, a significant relationship was found between patients with positive lymph nodes and patients with negative lymph nodes in terms of preoperative CA125 values, the positivity or negativity of peritoneal washings and histological types of tumors. Discussion We could not determine any effects of preoperative CA125 values, histological type of tumor and peritoneal cytology on the number of positive lymph nodes. Pelvic and para-aortic lymphadenectomy must be performed for us until the factors that affect nodal involvement will be described further in larger and more comprehensive studies.