• Giorgio Bogani, Elena Tagliabue, Antonino Ditto, Mauro Signorelli, Fabio Martinelli, Jvan Casarin, Valentina Chiappa, Giulia Dondi, Umberto Leone Roberti Maggiore, Cono Scaffa, Chiara Borghi, Luca Montanelli, Domenica Lorusso, and Francesco Raspagliesi.
• Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
• Gynecol. Oncol. 2017 Oct 1; 147 (1): 61-65.

ObjectiveTo estimate the prevalence of lymph node involvement in early-stage epithelial ovarian cancer in order to assess the prognostic value of lymph node dissection.MethodsData of consecutive patients undergoing staging for early-stage epithelial ovarian cancer were retrospectively evaluated. Logistic regression and a nomogram-based analysis were used to assess the risk of lymph node involvement.ResultsOverall, 290 patients were included. All patients had lymph node dissection including pelvic and para-aortic lymphadenectomy. Forty-two (14.5%) patients were upstaged due to lymph node metastatic disease. Pelvic and para-aortic nodal metastases were observed in 22 (7.6%) and 42 (14.5%) patients. Lymph node involvement was observed in 18/95 (18.9%), 1/37 (2.7%), 4/29 (13.8%), 11/63 (17.4%), 3/41 (7.3%) and 5/24 (20.8%) patients with high-grade serous, low-grade-serous, endometrioid G1, endometrioid G2&3, clear cell and undifferentiated, histology, respectively (p=0.12, Chi-square test). We observed that high-grade serous histology was associated with an increased risk of pelvic node involvement; while, histology rather than low-grade serous and bilateral tumors were independently associated with para-aortic lymph node involvement (p<0.05). Nomograms displaying the risk of nodal involvement in the pelvic and para-aortic areas were built. High-grade serous histology and bilateral tumors are the main characteristics suggesting lymph node positivity.ConclusionsOur data suggested that high-grade serous and bilateral early-stage epithelial ovarian cancer are at high risk of having disease harboring in the lymphatic tissues of both pelvic and para-aortic area. After receiving external validation, our data will help to identify patients deserving comprehensive retroperitoneal staging.Copyright © 2017 Elsevier Inc. All rights reserved.

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