An Analysis of Pelvic and Para-aortic Lymph Node Metastasis in Ovarian Carcinoma by Systematic Retroperitoneal Lymph Node Dissection

NDL Digital Collections 15 References
  • TSUMURA,Norihiko
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • SAKURAGI,Noriaki
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • HAREYAMA,Hitoshi
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • NOMURA,Eiji
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • OHKOUCHI,Toshihiro
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • YAMAMOTO,Ritsu
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • TAKEDA,Naoki
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • NISHIYA,Masashi
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • HIRAHATAKE,Koji
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • FUJINO,Takafumi
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • OKUBO,Hitoshi
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • SATOH,Chikara
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • MAKINODA,Satoru
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine
  • KAWAGUCHI,Isao
    Division of Obstetrics and Gynecology, Obihiro Kosei Hospital
  • FUJIMOTO,Seiichiro
    Department of Obstetrics and Gynecology, Hokkaido University School of Medicine

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Other Title
  • 系統的後腹膜リンパ節郭清に基づく卵巣癌における骨盤および傍大動脈リンパ節転移の検討

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We performed a systematic retroperitoneal lymph node dissection (RPLND) on 137 patients with primary ovarian carcinoma, of whom 97 had undergone RPLND during the primary surgery before chemotherapy and 40 had undergone RPLND during the secondary cytoreductive surgery after preoperative chemotherapy. The tentative staging of the ovarian carcinoma used in this study was determined according to the FIGO criteria without considering the pathologic findings of retroperitoneal lymph nodes. Nodal metastasis was seen in 21.9% (30/137) of them. Thirteen had positive pelvic lymph nodes (PLN) but no positive para-aortic nodes (PAN). Eleven had both positive PLN and positive PAN. Six had positive PAN but no positive PLN. The PAN was the most frequent site of metastasis (17/137). Next were the common iliac, obturator, and lateral group of deep inguinal nodes. Solitary metastasis in the patients who had undergone RPLND during the primary surgery was seen in a PAN and a common iliac node. Among 24 patients with PLN metastasis, there was a significant (p<0.05) difference in the number of positive PLN between the patients with PAN metastasis (5.27±3.00) and the patients without PAN metatasis (2.62±1.66). These results indicate that the PAN and common iliac nodes are the most important site of nodal metastasis in ovarian carcinoma. The metastasis to PLN such as obturator node and internal iliac node seems to occur independently of the PAN metastasis, and the PAN metastasis occurs not only through the direct route but also as a consequence of extension of PLN metastases. Systematic retroperitoneal lymph node exploration therefore seems to be necessary to clarify the lymph node status.

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