Pelvic and Para-aortic Lymph Node Positivity Rate in CA Ovary in Post-Neoadjuvant Chemotherapy Cases

Abstract

Background: Ovarian cancer, often characterized as the "silent killer," presents a substantial challenge in the realm of gynecological malignancies due to its insidious onset and advanced stage at diagnosis. Neoadjuvant chemotherapy (NACT) has emerged as a pivotal strategy in the treatment of advanced ovarian cancer, providing an alternative to upfront cytoreductive surgery. The prevalence of lymph node metastasis in ovarian cancer patients post-NACT remains uncertain, yet it holds profound clinical significance.

Material & Methods: We conducted a retrospective cohort study to investigate the pelvic and para-aortic lymph node positivity rate in ovarian cancer patients who underwent NACT. Data from electronic medical records, registries, and literature were reviewed. Inclusion criteria comprised patients with advanced-stage ovarian cancer (FIGO stage III or IV) and complete lymph node status information. The assessment of lymph node status involved radiological imaging and intraoperative evaluation. Histopathological analysis was performed when surgical lymph node dissection was carried out.

Results: Our study revealed a 30% prevalence of lymph node involvement post-NACT, consistent with previous studies. Factors such as histological subtype, age, and initial tumor stage were associated with lymph node positivity. The choice of neoadjuvant chemotherapy regimens did not significantly impact lymph node positivity. Patients with lymph node involvement had significantly shorter progression-free and overall survival. These findings underscore the clinical implications of lymph node metastasis in guiding therapeutic strategies.

Conclusion: The prevalence of lymph node metastasis in advanced ovarian cancer following NACT emphasizes the importance of meticulous lymph node assessment. Our results support considering lymph node status in treatment decision-making to improve patient care and prognosis. This study contributes to the growing body of knowledge surrounding advanced ovarian cancer management.