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Mesenteric Lymph Node Involvement as a Prognostic Factor in Ovarian Cancer: A Study Using a Standardized Detection

Yoshifumi Shimada¹, Koji Nishino², Junki Hasegawa²

¹Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. shimaday@med.niigata-u.ac.jp.

Annals of Surgical Oncology

|July 12, 2025

Summary

Mesenteric lymph node (MLN) involvement is a significant prognostic factor in ovarian cancer (OC) patients, especially after complete cytoreductive surgery. Standardized MLN detection aids in identifying patients with a poorer prognosis.

Keywords:

Clinical significance Complete cytoreductive surgery Mesenteric lymph node involvement Ovarian cancer Prognostic factor Rectosigmoid resection Standardized detection method

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Quantitation of Intra-peritoneal Ovarian Cancer Metastasis

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Published on: July 18, 2016

Area of Science:

Oncology
Surgical Oncology
Gynecologic Oncology

Background:

Mesenteric lymph node (MLN) involvement is common in ovarian cancer (OC) with rectosigmoid invasion.
Current MLN detection methods lack standardization, leading to controversial clinical significance.
This study addresses the need for a standardized approach to evaluate MLN involvement in OC.

Purpose of the Study:

To investigate the clinical significance of MLN involvement in ovarian cancer (OC) patients.
To establish a standardized method for MLN detection and histopathologic examination.
To correlate MLN status with patient prognosis following cytoreductive surgery.

Main Methods:

A cohort of 171 patients with stage II-IV OC undergoing cytoreductive surgery was analyzed.
For patients with rectosigmoid resection, systematic regional lymph node dissection and MLN examination were performed, mirroring colorectal cancer protocols.
Histopathologic examination was used to confirm MLN involvement.

Main Results:

MLNs were detected in 98.2% of patients undergoing rectosigmoid resection (n=57), with a median of nine nodes examined.
MLN involvement was confirmed in 30 of these patients.
MLN involvement independently predicted progression-free survival (P=0.010) and was significantly associated with worse prognosis in patients who underwent complete cytoreductive surgery (P<0.001).

Conclusions:

MLN involvement is a crucial prognostic factor in ovarian cancer (OC), particularly after complete cytoreductive surgery.
Standardized MLN evaluation, similar to colorectal cancer protocols, can identify OC patients at higher risk of poor prognosis.
This standardized approach enhances risk stratification and may guide treatment decisions.