[The surgical treatment of ovarian cancer]

Between 1980 and 1988, 350 women suffering from ovarian cancer stage I-IV were admitted to the Department of Gynaecology and Obstetrics of the University of Graz. 320 patients underwent surgery, 174 of 175 with stage III disease, 95 patients had a pelvic lymphadenectomy and 76 both pelvic and para-aortic lymphadenectomy. During the last 4 years, 75% of all patients with stage III disease underwent lymphadenectomy; in 30% the abdomen could be completely cleared of the disease. Bowel resection was necessary in 29% of these patients. After surgery and adjuvant chemotherapy, actuarial 5-year survival was 80% in stage I, 65% in stage II. and 45% in stage III. Lymph node status and amount of residual tumour were the most important factors affecting survival. After pelvic lymphadenectomy 23% patients of stage III showed no evidence of disease (NED) after 5 years. If there was no residual tumour at primary surgery, survival with NED increased to 62% and to 71% in patients with negative pelvic nodes. The data indicates, that pelvic lymphadenectomy improved the 5-year survival of patients with stage II-IV ovarian cancer.