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Impact of retroperitoneal lymph node dissection in ovarian cancer – time for paradigm shift?

  • Sara Tato-Varela EMAIL logo and Walther Kuhn
Published/Copyright: August 9, 2019

Abstract

Ovarian cancer is the second most common malignant neoplasm of the genital tract. Staging procedures for ovarian cancer include longitudinal laparotomy, hysterectomy, bilateral salpingo-oophorectomy and infragastric omentectomy as well as systematic pelvic and para-aortic lymphadenectomy. In general, the goal of this primary procedure is to achieve the maximum cytoreduction of all abdominal diseases; a residual disease <1 cm defines optimal cytoreduction, however, a maximal effort should be made to remove all gross disease as this offers superior survival outcomes. The role of lymphadenectomy in ovarian cancer has been the focus of gynecological oncologists during recent years. The core issue of the controversy is whether the removal of lymph nodes should be performed only to stage the disease or if the removal itself improves survival. To further comprehend the issue, one must take into account that several studies have shown that systematic lymphadenectomy is associated with a risk of vascular injury, lymph cyst formation, pulmonary embolism and increased post-operative mortality even when performed by surgeons with extensive experience. We present an extensive review of the available literature on the matter, hoping to provide some insight into the true need for such a procedure.

Author Statement

  1. Research funding: None declared.

  2. Conflict of interest: None declared.

  3. Informed consent: Not applicable.

  4. Ethical approval: Not applicable.

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Received: 2019-05-07
Accepted: 2019-07-11
Published Online: 2019-08-09

©2019 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Special Section: "Update in the management of ovarian cancer"; Guest Editors: René Druckmann and Adolf E. Schindler
  2. Editorial
  3. Preface to special issue: update in the management of ovarian cancer
  4. Original Article
  5. Ovarian cancer screening in the general population
  6. Review Articles
  7. Non-surgical prevention strategies in women with hereditary breast and ovarian cancer syndromes
  8. Hyperthermic intraperitoneal chemotherapy in ovarian cancer: an update
  9. Genetic testing in ovarian cancer – clinical impact and current practices
  10. The place of secondary complete cytoreductive surgery in advanced ovarian cancer
  11. An update on preoperative assessment of the resectability of advanced ovarian cancer
  12. Impact of retroperitoneal lymph node dissection in ovarian cancer – time for paradigm shift?
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