Lymphadenectomy in ovarian cancer

Current guidelines for the surgical staging of ovarian cancer include the r emoval of retroperitoneal lymph nodes (pelvic and aortic). In most centres this is achieved by means of laparotomy, but advanced laparoscopic techniqu es have also been performed and still further prospective controlled studie s with long-term follow-up are necessary to validate the efficacy. Lymph no de sampling, short of complete dissection, should be avoided because it may be insufficient to detect metastasis. In any case, laparoscopic lymphadene ctomy as well as open surgery, should be in the hands of properly trained s ubspecialists in gynaecologic oncology. Of 97 patients with ovarian carcino ma studied in our hospital, 68% were treated by means of complete staging l aparotomy (FIGO). Lymphadenectomy was spared in 14, cases with stage I tumo urs (mainly serous) without changes in overall survival. In 15% metastases in pelvic lymph nodes: were present. In the same proportion aortic lymph no des were positive. In 5.5%, aortic metastases were present in the absence o f pelvic involvement.