Published: 2017-02-20

Pelvic lymphadenectomy as a component of interval cytoreduction for ovarian cancer: is there a benefit? A pilot study

D. Suresh Kumar, S. Navin Noushad, M. P. Viswanathan


Background: Management strategy in ovarian cancer includes a combination of cytoreductive surgery and chemotherapy. Interval cytoreductive surgery has been shown to be oncologically non-inferior to primary cytoreduction with the additional benefit of reduced morbidity. Lymphadenectomy as a component of cytoreductive surgery has been controversial with an unproven therapeutic benefit.

Methods: Records of patients with a histological diagnosis of ovarian cancer and treated with interval cytoreduction were evaluated. Disease related, pathological and treatment data collected for analysis.

Results: The study included 32 patients with a mean age of 56 years (41-76). Serous papillary tumors (42%) were the predominate histology and the majority were in stage III disease (84%). Optimal cytoreduction was achieved in 93%. The mean nodal harvest was 9.8 nodes with left pelvic dissection yielding slightly more nodes than the right (4.5 vs 5.2). Nodal positivity was observed in just one patient (3%). A total of 314 were nodes examined with only 2 (0.6%) yielding persistent disease. The nodal positivity yield tested as a categorical variable by the binomial test returned P=0.0001.

Conclusions: It is possible to omit pelvic nodal dissection during interval cytoreduction in otherwise optimally cytoreduced patients particularly when imaging and intraoperative assessment are not suggestive of pelvic nodal metastasis.


Interval cytoreduction, Ovarian cancer, Pelvic lymphadenectomy

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