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Detailed Structure and Function of Lymph Nodes01:23

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The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
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Related Experiment Video

Updated: Jan 22, 2026

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Extracapsular Lymph Node Involvement in Ovarian Carcinoma.

Sabine Heublein1,2, Heiko Schulz3, Frederik Marmé4

  • 1Department of Obstetrics and Gynecology, Heidelberg University Hospital, Ruprecht-Karls-University of Heidelberg, 69120 Heidelberg, Germany. sabine.heublein@med.uni-heidelberg.de.

Cancers
|July 4, 2019
PubMed
Summary

Extracapsular spread (ECG) in lymph nodes is common in ovarian cancer (OC). This pattern, along with a high lymph node ratio, indicates poorer prognosis and suggests increased tumor aggressiveness.

Keywords:
extra-capsular growthlymph node metastasisovarian cancerprognosis

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Area of Science:

  • Oncology
  • Pathology

Background:

  • Ovarian cancer frequently metastasizes to retroperitoneal lymph nodes.
  • The prognostic significance of the pattern of lymph node involvement (intracapsular vs. extracapsular growth) is not well understood.

Purpose of the Study:

  • To determine the prevalence of extracapsular growth (ECG) in lymph node-positive ovarian cancer.
  • To investigate the association between ECG and patient prognosis.
  • To explore whether primary tumor biomarkers can predict ECG.

Main Methods:

  • Analysis of lymph node samples from 143 ovarian cancer patients for ECG.
  • Statistical association testing of ECG with clinico-pathological variables.
  • Evaluation of 27 biomarkers from primary tumors for ECG prediction.

Main Results:

  • ECG was present in 24.5% of lymph node-positive ovarian cancer patients.
  • ECG correlated positively with high tumor grade, specific histologic subtypes, and high lymph node ratio (LNR).
  • Both ECG and high LNR were predictive of shortened overall survival.

Conclusions:

  • Extracapsular spread is a frequent finding in lymph node-metastatic ovarian cancer.
  • ECG serves as a potential indicator of tumor aggressiveness and is associated with poorer patient outcomes.
  • A four-protein signature in primary tumors may predict ECG in lymph node metastases.