Assessment of metastases to aortic and pelvic lymph nodes in epithelial ovarian carcinoma: A proposal for essential sites for lymph node biopsy

✍ Scribed by Takashi Onda; Hiroyuki Yoshikawa; Harushige Yokota; Toshiharu Yasugi; Yuji Taketani

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 526 KB
• Volume: 78
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19960815)78:4<803::aid-cncr17>3.0.co;2-z

✦ Synopsis

BACKGROUND.

In staging epithelial ovarian carcinoma, it is necessary to assess the presence of lymph node metastases. However, the essential sites of selective lymph node biopsy have yet to be determined.

METHODS.

The distribution of metastatic aortic and pelvic lymph nodes was studied in 48 patients with positive lymph nodes of 110 patients with ovarian carcinoma who underwent systematic lymphadenectomy of the aortic and pelvic regions extending to the level of the renal vessels. For purpose of analysis, the lymph nodes were classified into five subgroups: the aortic lymph nodes above the inferior mesenteric artery (Al), the aortic lymph nodes below the inferior mesenteric artery (MI, the common iliac and sacral lymph nodes (Pl), the internal and external iliac and obturator lymph nodes (P2), and the suprainguinal (the lowest external iliac) lymph nodes (P3).

RESULTS.

The incidence of metastases to A l , A2, P1, P2, and P3 was 79%, 71%, 46%, 77%, and 40%, respectively. Provided that 2 of the 5 lymph node subgroups were selected for biopsy, the combination of A1 and P2 gave the best results in sensitivity (94% [45 of 48 patients]) and negative (95% 162 of 65 patients]) predictive value for detection of lymph node metastases.