RETROPERITONEAL LYMPHADENECTOMY, INCLUDING THE PARAAORTIC NODES IN PATIENTS WITH STAGE-III OVARIAN-CANCER

The role of lymphadenectomy in patients with advanced ovarian cancer i s controversial. To evaluate the effect of lymphadenectomy, we retrosp ectively assessed the outcome of 53 patients with stage III epithelial ovarian cancer who were divided into two groups, which were matched f or age distribution and postoperative chemotherapy, but received diffe rent surgical procedures. A total of 29 patients (group A) underwent h ysterectomy, bilateral salpingoophorectomy, omentectomy, and retroperi toneal lymphadenectomy, including resection of the para-aortic nodes. The remaining 24 patients (group B) received hysterectomy, bilateral s alpingoophorectomy, and omentectomy without retroperitoneal lymphadene ctomy. Postoperative chemotherapy consisted of a combination of cispla tin, Adriamycin, and cyclophosphamide in both groups. The 2-year survi val rate for group A was significantly greater than that for group B, but there was no significant difference between the groups with regard to the estimated 5-year survival rate. The 2-year survival rate of pa tients with positive nodes who underwent lymphadenectomy was similar t o that of patients with negative nodes. Multivariate analysis indicate d that lymph node involvement did not relate to prognosis of the patie nts undergoing lymphadenectomy. While a defined randomized trial is re quired to reach substantive conclusion, it is suggested that lymphaden ectomy may be useful for improvement of the prognosis of patients with advanced ovarian cancer.