[Lymph node dissection in early ovarian cancer]

Abstract

Aim: Our aim was to evaluate and summarize our experience in surgical treatment for early ovarian cancer, the way and extend of metastases, as well as the need and effectiveness of applying radical pelvic and paraaortic lymph node dissection. We compared our results with the results of prominent clinics all over the world in this special field.

Material and methods: We researched retrospectively patients, operated for early ovarian cancer for 15 years period. We evaluated the use of lymph node dissection and the level of its radicality. Examining the volume and borders of the lymph node dissection we tried to sintesize the main practical conclusions and refferences, which can be applied practically by the colleagues working in gynaecological and oncogynaecological clinics in our country

Results: According to us and the most foreign authors the ovarian cancer, must be removed intact, and frozen section biopsy must be used. The surgical staging includes: total abdominal histerectomy, bilateral salpingooophorectomy and total pelvic and/or paraaortic lymph node dissection. The surgical staging in all patients is obligatory and includes: a) cytological examination of ascites. b) when ascites is absent--cytological smear. c) Examination of intraabdominal organs and surfaces. d) Biopsies are taken from all suspicious regions. e) The diaphragm is examined by biopsy and scraping. f) Infracolic omentectomy is performed. g) Retroperitoneal spaces are dissected and examined. h) The paraaortal area is examined. When enlarged lymph nodes are found--they are resected and examined. If enlarged paraaortal lymph nodes are found--total paraaortic lymph node dissection is performed.

Discussion: The extend of the lymph node dissection in early ovarian cancer is connected with better survical rate in these patients.

Conclusions: The lymph node dissection helps for precise surgical staging in early ovarian cancer. The volume of the lymph node dissection is significant prognostic factor for better survical rate, as well as age, stage, histological type and the grade of the disease.