Regional lymphadenectomy in advanced ovarian cancer: The enigma continues

doi:10.5412/wjsp.v10.i1.1

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World Journal of Surgical Procedures

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2219-2832

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Surg Proced. Jan 3, 2020; 10(1): 1-2
Published online Jan 3, 2020. doi: 10.5412/wjsp.v10.i1.1

Regional lymphadenectomy in advanced ovarian cancer: The enigma continues

Pankaj Kumar Garg, Sandipan Chowdhury, Rajkumar K Seenivasagam, Dharma Ram Poonia

Pankaj Kumar Garg, Rajkumar K Seenivasagam, Dharma Ram Poonia, Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India

Sandipan Chowdhury, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India

Author contributions: Garg PK wrote the initial draft; all the authors read the final draft and approved it.

Conflict-of-interest statement: The authors have no conflicts of interests to declare.

Corresponding author: Pankaj Kumar Garg, MS, DNB, MCh, FACS, Additional Professor, Department of Surgical Oncology, All India Institute of Medical Sciences, Veerbhadra Marg, Rishikesh, Uttarakhand 249203, India. dr.pankajgarg@gmail.com

Received: July 11, 2019
Peer-review started: July 17, 2019
First decision: November 12, 2019
Revised: November 19, 2019
Accepted: December 23, 2019
Article in press: December 23, 2019
Published online: January 3, 2020
Processing time: 170 Days and 8.3 Hours

Abstract

The role of regional lymphadenectomy has always been a matter of discussion in the surgical management of solid tumors – Pelvic and para-aortic lymphadenectomy in ovarian cancer is one such issue. A recently published randomized trial suggested that regional lymphadenectomy in patients with advanced ovarian cancer is unlikely to offer a survival advantage. However, para-aortic and pelvic lymphadenectomy is warranted in the presence of macroscopically suspicious nodes to achieve complete cytoreduction. A long-term follow-up of the trial will demonstrate whether a prophylactic regional lymphadenectomy is associated with survival benefit in a subgroup of patients with advanced ovarian cancer who have grossly normal regional lymphnodes as evident in a widely open retroperitoneum.

Keywords: Ovarian cancer; Lymphadenectomy; Survival; Retroperitoneum

Core tip: Para-aortic and pelvic lymphadenectomy is warranted in macroscopically suspicious nodes in patients with advanced ovarian cancer to achieve complete cytoreduction.