scholarly journals Recurrent Metastasis of Epithelial Ovarian Cancer in Cervical, Submandibular and Suboccipital Lymph Nodes

1970 ◽  
Vol 10 (2) ◽  
pp. 128-131
Author(s):  
Azam Sadat Mousavi ◽  
Fariba Behnamfar ◽  
Nili Mehrdad
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Ovarian Carcinoma ◽  
Epithelial Ovarian Cancer ◽  
Cause Of Death ◽  
Gynecologic Cancer ◽  
Metastatic Tumor ◽  
Recurrent Ovarian Cancer ◽  
Gynecologic Malignancy

Ovarian carcinoma is the second most common gynecologic cancer and the leading cause of death from gynecologic malignancy. The management of recurrent ovarian cancer has been individualized. Reports of recurrence in supradiaphragmatic lymph nodes are rare. We describe the finding of metastatic tumor involving cervical, submandibular and suboccipital lymph nodes in a 77-year-old patient with ovarian carcinoma. Keywords: scalene lymph node, ovarian cancer, lymphadenopathy, recurrence   doi: 10.3329/jom.v10i2.2830   J MEDICINE 2009; 10 : 128-131

Sentinel-node biopsy in early stage ovarian cancer: a prospective multicentre study (SELLY)

2019 ◽  
Vol 29 (9) ◽  
pp. 1437-1439
Author(s):  
Giovanni Scambia ◽  
Camilla Nero ◽  
Stefano Uccella ◽  
Enrico Vizza ◽  
Fabio Ghezzi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Indocyanine Green ◽  
Epithelial Ovarian Cancer ◽  
Sample Size ◽  
Early Stage ◽  
Sentinel Lymph Nodes ◽  
Exclusion Criteria

BackgroundSystematic para-aortic and bilateral pelvic lymphadenectomy is included in the standard comprehensive surgical staging in presumed early epithelial ovarian cancer. No prospective randomized evidence suggests it has potential therapeutic value, and related morbidity is not negligible.Primary Objective(s)To assess sensitivity, safety, and feasibility of the sentinel lymph node technique in identifying the presence of lymph node metastases in patients with early stage epithelial ovarian cancer.Study HypothesisSentinel lymph node detection with indocyanine green can accurately predict nodal status in a cohort of women with early stage epithelial ovarian cancer.Trial DesignThe SELLY trial is a prospective phase II interventional multicenter study.Major Inclusion/Exclusion CriteriaInclusion criteria: Eastern Cooperative Oncology Group 0–1, apparent International Federation of Gynecology and Obstetrics (FIGO) stage I-II, histologically proven epithelial ovarian cancer.Exclusion criteria: evidence of carcinomatosis, mucinous only at definitive histology.Endpoint(s)Primary endpoint is sensitivity (true positive rate). Secondary endpoints include safety (complications rate of the procedure) and feasibility.Sample SizeAssuming a sensitivity of 98.5% in predicting positive sentinel lymph nodes at histology, a pathological lymph node prevalence of 14.2%, a precision of estimate (ie, the maximum marginal error) d=5%, and a type I error α=0.05, a sample size of 160 patients is needed to test the general hypothesis (ie, to answer whether sentinel lymph nodes identified with indocyanine green can accurately predict nodal status at histology of patients with apparently early epithelial ovarian cancer). Assuming a drop-out rate of 10%, a total of 176 patients will be enrolled in the study.Estimated Dates for Completing Accrual and Presenting ResultsThe accrual should be completed by December 2020 and results should be presented by March 2021.Trial RegistrationThe trial is registered at clinicaltrials.gov (NCT03563781).

Pattern and clinical predictors of lymph node metastases in epithelial ovarian cancer

2007 ◽  
Vol 17 (6) ◽  
pp. 1238-1244 ◽  
Author(s):  
P. Harter ◽  
K. Gnauert ◽  
R. Hils ◽  
T. G. Lehmann ◽  
A. Fisseler-Eckhoff ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Epithelial Ovarian Cancer ◽  
Lymph Node Metastases ◽  
Frozen Section ◽  
Vena Cava ◽  
Lymph Node Involvement ◽  
Clinical Predictors ◽  
Node Metastases

Para-aortic lymphadenectomy is part of staging in early epithelial ovarian cancer (EOC) and could be part of therapy in advanced EOC. However, only a minority of patients receive therapy according to guidelines or have attendance to a specialized unit. We analyzed pattern of lymphatic spread of EOC and evaluated if clinical factors and intraoperative findings reliably could predict lymph node involvement, in order to evaluate if patients could be identified in whom lymphadenectomy could be omitted and who should not be referred to a center with capacity of performing extensive gynecological operations. Retrospective analysis was carried out of all patients with EOC who had systematic pelvic and para-aortic lymphadenectomy during primary cytoreductive surgery. One hundred ninety-five patients underwent systematic pelvic and para-aortic lymphadenectomy. Histologic lymph node metastases were found in 53%. The highest frequency was found in the upper left para-aortic region (32% of all patients) and between vena cava inferior and abdominal aorta (36%). Neither intraoperative clinical diagnosis nor frozen section of pelvic nodes could reliably predict para-aortic lymph node metastasis. The pathologic diagnosis of the pelvic nodes, if used as diagnostic tool for para-aortic lymph nodes, showed a sensitivity of only 50% in ovarian cancer confined to the pelvis and 73% in more advanced disease. We could not detect any intraoperative tool that could reliably predict pathologic status of para-aortic lymph nodes. Systematic pelvic and para-aortic lymphadenectomy remains part of staging in EOC. Patients with EOC should be offered the opportunity to receive state-of-the-art treatment including surgery

scholarly journals Treatment of epithelial ovarian cancer

BMJ ◽  
2020 ◽  
pp. m3773
Author(s):  
Lindsay Kuroki ◽  
Saketh R Guntupalli
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Gene Mutations ◽  
Disease Process ◽  
Standard Of Care ◽  
Integrated Approach ◽  
Recurrent Ovarian Cancer ◽  
Gynecologic Malignancy ◽  
Medical Oncologists

ABSTRACTOvarian cancer is the third most common gynecologic malignancy worldwide but accounts for the highest mortality rate among these cancers. A stepwise approach to assessment, diagnosis, and treatment is vital to appropriate management of this disease process. An integrated approach with gynecologic oncologists as well as medical oncologists, pathologists, and radiologists is of paramount importance to improving outcomes. Surgical cytoreduction to R0 is the mainstay of treatment, followed by adjuvant chemotherapy. Genetic testing for gene mutations that affect treatment is the standard of care for all women with epithelial ovarian cancer. Nearly all women will have a recurrence, and the treatment of recurrent ovarian cancer continues to be nuanced and requires extensive review of up to date modalities that balance efficacy with the patient’s quality of life. Maintenance therapy with poly ADP-ribose polymerase inhibitors, bevacizumab, and/or drugs targeting homologous recombination deficiency is becoming more widely used in the treatment of ovarian cancer, and the advancement of immunotherapy is further revolutionizing treatment targets.

Frequency and Distribution of Lymph Node Metastases in Epithelial Ovarian Cancer: Significance of Serous Histology

2011 ◽  
Vol 21 (2) ◽  
pp. 245-250 ◽  
Author(s):  
Herman Haller ◽  
Ozren Mamula ◽  
Maja Krasevic ◽  
Stanislav Rupcic ◽  
Alemka Brncic Fischer ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Epithelial Ovarian Cancer ◽  
Left Renal Vein ◽  
Ovarian Carcinomas ◽  
Systematic Lymphadenectomy ◽  
Chemotherapy Administration ◽  
Node Distribution ◽  
Positive Lymph Nodes

Background:The aim of this retrospective study was to evaluate the incidence and distribution of nodal metastases in relation to the serous versus nonserous histological subtypes of epithelial ovarian cancer.Methods:Patients were treated primarily with upfront surgery, including pelvic and para-aortic systematic lymphadenectomy, up to the level of the left renal vein, before any kind of chemotherapy administration. Patients were classified according the tumor histology into 2 groups: serous (including the cases of mixed histology with a serous component) and nonserous group.Results:A total of 173 patients fulfilled the inclusion criteria; 76 and 97 patients had serous and nonserous ovarian carcinoma, respectively. Positive lymph nodes were found in 59.3% (45/76) and 14.4% (14/97) of patients in the serous and nonserous histology groups, respectively. There was no difference in positive node distribution in 3 regions (pelvic and para-aortic regions, below and above the inferior mesenteric artery) between these 2 groups. Early spread including 1 or 2 positive lymph nodes was predominantly found in the para-aortic region in both groups, serous and nonserous, whereas distribution of positive nodes in patients with 3 or more lymph nodes shows equal presence in pelvic and para-aortic regions.Conclusions:Serous ovarian carcinomas are much more prone to metastasize to lymph nodes than nonserous histological types. However, the pattern of lymph node distribution did not differ between these 2 groups and was similar in the pelvic and para-aortic regions.

Paraparesis: a rare primary presentation of epithelial ovarian cancer

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 293-294
Author(s):  
R. Wuntkal ◽  
A. Maheshwari ◽  
S. Gupta ◽  
H. Tongaonkar
Keyword(s):  
Ovarian Cancer ◽  
Spinal Cord ◽  
Lymph Nodes ◽  
Ovarian Carcinoma ◽  
Epithelial Ovarian Cancer ◽  
Spinal Cord Compression ◽  
Unusual Case ◽  
Cord Compression ◽  
Epithelial Ovarian Carcinoma ◽  
Primary Presentation

The usual modes of spread of ovarian epithelial carcinomas are by exfoliation of cells into the peritoneal cavity and lymphatic dissemination to retroperitoneal lymph nodes. Primary presentation of ovarian carcinoma due to neurologic symptoms of spinal cord compression is extremely rare. We report an unusual case of epithelial ovarian carcinoma who primarily presented with paraparesis due to spinal extradural metastasis.

scholarly journals Clinical Impact of Lymphadenectomy after Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer: A Review of Available Data

2021 ◽  
Vol 10 (2) ◽  
pp. 334
Author(s):  
Stephanie Seidler ◽  
Meriem Koual ◽  
Guillaume Achen ◽  
Enrica Bentivegna ◽  
Laure Fournier ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Lymph Node Dissection ◽  
Prospective Trial ◽  
Node Dissection ◽  
Advanced Epithelial Ovarian Cancer ◽  
The Impact ◽  
Systematic Lymph Node Dissection

Recent robust data allow for omitting lymph node dissection for patients with advanced epithelial ovarian cancer (EOC) and without any suspicion of lymph node metastases, without compromising recurrence-free survival (RFS), nor overall survival (OS), in the setting of primary surgical treatment. Evidence supporting the same postulate for patients undergoing complete cytoreductive surgery after neoadjuvant chemotherapy (NACT) is lacking. Throughout a systematic literature review, the aim of our study was to evaluate the impact of lymph node dissection in patients undergoing surgery for advanced-stage EOC after NACT. A total of 1094 patients, included in six retrospective series, underwent either systematic, selective or no lymph node dissection. Only one study reveals a positive effect of lymphadenectomy on OS, and two on RFS. The four remaining series fail to demonstrate any beneficial effect on survival, neither for RFS nor OS. All of them highlight the higher peri- and post-operative complication rate associated with systematic lymph node dissection. Despite heterogeneity in the design of the studies included, there seems to be a trend showing no improvement on OS for systematic lymph node dissection in node negative patients. A well-conducted prospective trial is mandatory to evaluate this matter.

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