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Updated: Sep 25, 2026

Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
[Significance of systematic retroperitoneal lymphadenectomy at second-look laparotomy for ovarian cancer]
Zhi-yi Zhang1, Rong-yu Zang, Mei-qin Tang
1Department of Gynecological Oncology, Cancer Hospital of Fudan University, Shanghai 200032, China.
Objective:
To investigate the timing and role of systemic retroperitoneal lymphadenectomy in patients with ovarian cancer.
Methods:
From Jan. 1987 to Feb. 1994, 50 patients with ovarian cancer, who underwent retroperitoneal lymphadenectomy on second-look laparotomy (SLL), were retrospectively studied.
Results:
The median age was 49 years. Overall survival at 3 and 5 years were 72% and 62%, respectively. Twenty of 50 (40%) women were found SLL(+), and the rates of positive SLL were related to International Federation of Gynecology Obstetrics (FIGO) stage, with 16% in stage I and II, 64% in stage III and IV (P < 0.01). Sixteen (32%) women were found to have retroperitoneal lymph nodes metastases at SLL, with 0% (0/15), 20% (2/10), 54% (13/24), 1/1 in stage I, II, III, IV respectively. In patients with SLL(+), 4 patients with sole disease in the pelvis, and 6 (12%) women only with micro-metastases of retroperitoneal lymph nodes. Fifteen patients with stage I ovarian cancer were all SLL(-), and SLL(-) were in 6 (60%) patients with stage II disease and 11 (38%) in stage III. There is no disease recurrence in patients with negative SLL till the data censored.
Conclusion:
Timing of systemic retroperitoneal lymphadenectomy at SLL is rational, and may aid in reducing disease recurrence of negative SLL and improving five-year survival rate in patients with ovarian cancer, especially in those with advanced epithelial ovarian cancer.
