Skip to main content

Value of Lymphadenectomy

  • Chapter
  • First Online:
Ovarian Cancers

Abstract

Systematic pelvic and para-aortic lymphadenectomy is a main part of surgical staging in early ovarian cancer and might be indicated in patients with advanced ovarian cancer. In contrast to other tumors like cervical or endometrial cancer, the lymphadenectomy is usually done by median laparotomy. The main reason is not only the appropriate removal from lymph nodes up to the renal veins, it’s also the possibility for complete inspection and palpation of the whole abdomen regarding possible peritoneal carcinomatosis, which is not possible by laparoscopy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Wagner U, Harter P, Hilpert F, et al. S3-guideline on diagnostics, therapy and follow-up of malignant ovarian tumours: short version 1.0 – AWMF registration number: 032/035OL, june 2013. Geburtshilfe Frauenheilkd. 2013;73(9):874–89.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lhommé C, Morice P, Planchamp F, et al. Clinical practice guidelines 2008 for the surgical treatment, medical first-line and consolidation treatments of patients with epithelial ovarian cancer–update. According to the methodology of Standards, Options: Recommendations (SOR). Bull Cancer. 2008;95(9):881–6.

    PubMed  Google Scholar 

  3. Trimbos JB, Vergote I, Bolis G, et al. Impact of adjuvant chemotherapy and surgical staging in early-stage ovarian carcinoma: european organisation for research and treatment of cancer-adjuvant chemotherapy in ovarian neoplasm trial. J Natl Cancer Inst. 2003;95:113–25.

    Article  CAS  PubMed  Google Scholar 

  4. Chan JK, Munro EG, Cheung MK, et al. Association of lymphadenectomy and survival in stage I ovarian cancer patients. Obstet Gynecol. 2007;109:12–9.

    Article  PubMed  Google Scholar 

  5. du Bois A, Rochon J, Lamparter C, Pfisterer J. The quality assurance program of the AGO organkommission OVAR (QS-OVAR): pattern of care and reality in Germany 2001. Zentralbl Gynakol. 2005;127(1):9–17.

    Article  PubMed  Google Scholar 

  6. Maggione A, Benedetti-Panici P, Dell’Anna T, et al. Randomised study of systematic lymphadenectomy in patients with epithelial ovarian cancer macroscopically confined to the pelvis. Br J Cancer. 2006;95:699–704.

    Article  Google Scholar 

  7. Onda T, Yoshikawa H, Yokota H, Yasugi T, Taketani Y. Assessment of metastases to aortic and pelvic lymph nodes in epithelial ovarian carcinoma. A proposal for essential sites for lymph node biopsy. Cancer. 1996;78(4):803–8.

    Article  CAS  PubMed  Google Scholar 

  8. Baiocchi G, Grosso G, di Re E, et al. Systematic pelvic and paraaortic lymphadenectomy at second-look laparotomy for ovarian cancer. Gynecol Oncol. 1998;69(2):151–6.

    Article  CAS  PubMed  Google Scholar 

  9. Harter P, Gnauert K, Hils R, et al. Pattern and clinical predictors of lymph node metastases in epithelial ovarian cancer. Int J Gynecol Cancer. 2007;17(6):1238–44.

    Article  CAS  PubMed  Google Scholar 

  10. Morice P, Joulie F, Camatte S, et al. Lymph node involvement in epithelial ovarian cancer: analysis of 276 pelvic and paraaortic lymphadenectomies and surgical implications. J Am Coll Surg. 2003;197:198–205.

    Article  PubMed  Google Scholar 

  11. Ataseven B, Grimm C, Harter P, et al. Prognostic value of lymph node ratio in patients with advanced epithelial ovarian cancer. Gynecol Oncol. 2014;135(3):435–40.

    Article  PubMed  Google Scholar 

  12. du Bois A, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: A combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials. Cancer. 2009;115(6):1234–44.

    Article  PubMed  Google Scholar 

  13. Bristow RE, Tomacruz RS, Armstrong DK, et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol. 2002;20:1248–59.

    Article  PubMed  Google Scholar 

  14. Winter 3rd WE, Maxwell GL, Tian C, et al. Prognostic factors for stage III epithelial ovarian cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2007;25:3621–7.

    Article  PubMed  Google Scholar 

  15. Morice P, Joulie F, Rey A, et al. Are nodal metastasis in ovarian cancer chemoresistant lesions? Analysis of nodal involvement in 105 patients treated with preoperative chemotherapy. Eur J Gynaecol Oncol. 2004;25:169–74.

    CAS  PubMed  Google Scholar 

  16. Benedetti Panici P, Maggione A, Hacker N, et al. Systematic aortic and pelvic lymphadenectomy versus resection of bulky nodes only in optimally debulked advanced ovarian cancer: a randomized clinical trial. J Natl Cancer Inst. 2005;97:560–5.

    Article  Google Scholar 

  17. Chambers SK. Systematic lymphadenectomy in advanced epithelial ovarian cancer: two decades of uncertainty resolved. J Natl Cancer Inst. 2005;97:548–9.

    Article  PubMed  Google Scholar 

  18. Spirtos NM, Gross GM, Freddo JL, Ballon SC. Cytoreductive surgery in advanced epithelial ovarian cancer of the ovary: the impact of aortic and pelvic lymphadenectomy. Gynecol Oncol. 1995;56:345–52.

    Article  CAS  PubMed  Google Scholar 

  19. Pereira A, Magrina JF, Rex V, Cortes M, Magtibay PM. Pelvic and aortic lymph node metastasis in epithelial ovarian cancer. Gynecol Oncol. 2007;67:10214–21.

    Google Scholar 

  20. Tangjitgamol S, Manusirivithaya S, Sheanakul C, et al. Can we rely on the size of lymph node in determining nodal metastases in ovarian cancer. Int J Gynecol Cancer. 2003;13:297–302.

    Article  CAS  PubMed  Google Scholar 

  21. Aletti GD, Dowdy S, Podratz KC, Cliby WA. Role of lymphadenectomy in the management of grossly apparent advanced stage epithelial ovarian cancer. Am J Obstet Gynecol. 2006;195:1862–8.

    Article  PubMed  Google Scholar 

  22. di Re F, Baiocchi G, Fontanelli R, et al. Systematic pelvic and paraaortic lymphadenectomy for advanced ovarian cancer: prognostic significance of node metastases. Gynecol Oncol. 1996;62:360–5.

    Article  PubMed  Google Scholar 

  23. Scarabelli C, Gallo A, Visentin MC, Canzonieri V, Carbone A, Zarelli A. Systematic pelvic and para-aortic lymphadenectomy in advanced ovarian cancer patients with no residual intraperitoneal disease. Int J Gynecol Cancer. 1997;7:18–26.

    Article  CAS  PubMed  Google Scholar 

  24. Crawford SC, Vasey PA, Paul J, Hay A, Davis JA, Kaye JB. Does aggressive surgery only benefit patients with less advanced ovarian cancer? Results from an international comparison within the SCOTROC-1 trial. J Clin Oncol. 2005;23:8802–11.

    Article  PubMed  Google Scholar 

  25. Chan JK, Urban R, Hu JM, et al. The potential therapeutic role of lymph node resection in epithelial ovarian cancer: a study of 13.918 patients. Br J Cancer. 2007;96:1817–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. du Bois A, Reuss A, Harter P, et al. Potential role of lymphadenectomy in advanced ovarian cancer: a combined exploratory analysis of three prospectively randomized phase III multicenter trials. J Clin Oncol. 2010;28(10):1733–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Philipp Harter .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Harter, P., Heitz, F., du Bois, A. (2017). Value of Lymphadenectomy. In: Pujade-Lauraine, E., Ray-Coquard, I., LĂ©curu, F. (eds) Ovarian Cancers. Springer, Cham. https://doi.org/10.1007/978-3-319-32110-3_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-32110-3_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-32108-0

  • Online ISBN: 978-3-319-32110-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics