Incidence of Pelvic and Paraaortic Lymph Node Metastasis in Epithelial Ovarian Cancer at a Tertiary Care Center

Abstract

Objective: To investigate the incidence of pelvic and paraaortic
lymph node metastasis in epithelial ovarian cancer.
Methods: This was a cross-sectional study. Data were collected
from medical records, and from the cancer registry 1539 medical
records were obtained. From there, 863 patients were operated
and 676 were not, and only 401 medical records were found
complete, and 306 samples were excluded because they have been
treated with NAC and underwent surgery, patients who underwent
surgery but the results is not the epithelium, and patients who
underwent surgery, but the results were benign or borderline. And
95 patients who underwent primary surgery and lymphadenectomy
only 55 patients have results in lymphadenectomy. This study uses
a calculation of sample size with categorial descriptions, with
precision of 3% then obtained a minimum sample size of 261
patients.
Results: According to the characteristics of the study subjects
above, the results were stage I, II, III respectively 60%, 10.9%, and
29%. The metastasized of the lymph node paraaortic 9.1%, and
pelvic/paraaortic 20% pelvic/paraaortic23.6%. Based on the
degree of differentiation the results were good differentiation
30.9%, moderate differentiation 23.6%, and poor differentiation
45.5%. We found that paraaortic lymph node metastasis were
most frequent at stadium III (43.8%). In relationship between
lymph node metastasis with differentiation of epithelial ovarian
cancer, the most frequent epithelial ovarian cancer were one with
poor differentiation in pelvic/paraaortic lymph node with the sum
of 69.2%. From analysis, there is significant difference between
serous hystologic subtype with mucinosum subtype in pelvic
lymph node, significant difference between serous hystologic
subtype and clear cell in paraorta or pelvic lymph node and
between the serous histology subtype and mucinous as well.
Conclusion: Lymph node metastasis incident of ovarian epithelial
cancer in paraaorta amounts 20%, pelvic 9.1% and pelvic or
paraaortic 23.6%. Higher the stadium, the lymph node involvements
will be higher as well (pelvic and paraaortic). In stadium 1
of mucinous subtype with well differentiation has minimal lymph
node involvement so we can be more selective in considering the
risk and benefit of lymphadenectomy.
[Indones J Obstet Gynecol 2018; 6-1: 60-63]
Keywords: lymph node metastasis, ovarian cancer