Management of advanced ovarian cancer

Since the end of 1979 extensive pelvic lymphadenectomy has been performed at the Graz University Clinic of Obstetrics and Gynecology in the operative treatment of ovarian cancer in stages Ib to IV. In 27 of 48 patients (56.3%) positive nodes were found. The frequency of involved nodes in stage III only was 61.1% (N = 22). The incidence of positive paraaortic nodes in 16 evaluated cases was 31.2%, but these were only found when pelvic nodes were involved too. In 12 cases lymphadenectomy was done in second-look laparotomy. It became apparent that after operative and cytotoxic treatment with Adriamycin, Cis-Platinum and Cyclophosphamide (following the regimen of Ehrlich et al.) pelvic lymphnodes were still found positive in 8 of 12 cases (66.7%). The distribution of the nodes involved showed that the caudal lymphnodes were more often affected that than cranial ones. The results so far suggest that extensive pelvic lymphadenectomy may improve survival rates of patients with advanced ovarian cancer.