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Lymph node sampling in patients with epithelial ovarian carcinoma.
G L Goldberg1, J Scheiner, A Friedman
1Department of Obstetrics and Gynecology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10461, USA.
Gynecologic Oncology
|November 1, 1992
Summary
For ovarian carcinoma staging, lymph node sampling during second look operations may be unnecessary. Patients with negative lymph nodes at initial surgery consistently show negative nodes later, suggesting primary sampling is sufficient.
Area of Science:
- Gynecologic Oncology
- Surgical Pathology
- Clinical Staging
Background:
- Lymph node sampling is integral to FIGO staging for ovarian carcinoma.
- It is typically performed during meticulous second look operations.
Purpose of the Study:
- To evaluate the necessity of lymph node sampling at second look operations.
- To compare primary lymph node status with status at second look surgery.
Main Methods:
- Retrospective analysis of 97 epithelial ovarian tumor patients (3/86-3/91).
- Comparison of lymph node status from primary surgery to second look operations.
- Analysis of lymph node sampling in 71 patients at primary surgery and 48 at second look.
Main Results:
- 42.2% of patients had positive lymph nodes at primary surgery; 18.7% had positive nodes at second look.
- All patients negative for lymph node metastasis at primary surgery remained negative at second look.
- Of patients with positive primary nodes, 8/12 were negative at second look, indicating clearance.
Conclusions:
- Lymph node sampling at second look operations for ovarian carcinoma may be superfluous.
- Patients with negative lymph nodes during primary surgery are highly unlikely to develop positive nodes later.
- This suggests primary lymph node assessment is adequate for staging in many cases.