Benefits of Systematic Pelvic and Para-Aortic Lymphadenectomy in Advanced Ovarian Epithelial Cancer

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Document Type : Original Article

Authors

1 Onco surgery department alazhar university faculty of medicine cairo

2 Department of surgical oncology, Faculty of medicine, Al-Azhar university, Cairo

Abstract

Background: Advanced ovarian epithelial cancer often requires extensive surgical management to improve patient outcomes. This study evaluates the benefits of systematic pelvic and para-aortic lymphadenectomy in terms of survival rates, operative parameters, and recovery in patients with advanced stages of the disease.

Patients and Methods: We performed an observational prospective study. The study was conducted at Al-Azhar University Hospital. We included a total of 50 female patients presenting with pe-lvi-abdominal swelling. We included two groups; Group one undergoing the conventional debulking surgery and Group Two group The same procedures as Group A, with the addition of systematic pelvic lymphadenectomy up to the level of the aortic bifurcation.

Results: As regards the LNs state, the mean number of the removed LNs was 26 with a range of (18-40). From these LNs, the mean number of malignant ones was 6 with a range of 0-13 (Table 2). The mean operative time was 121 minutes with arrange of 92 – 182 in group A versus 190 and a range of 125 – 285 in group B (P =0.001). The mean hospital stay duration was significantly longer in group B than group A (12 vs 8) (Table 3). In our study, 28% of the patients in group A, needed blood transfusion versus 80% of the patients in group B (P =0.002) (Table 4). As regards the recurrence rate, it was 72% of the patient in group A versus 60% of the patients in group (P=0.001).

Conclusion: Systematic pelvic and para-aortic lymphadenectomy in advanced ovarian epithelial cancer significantly enhances survival rates and improves operative and recovery parameters, despite a higher rate of postoperative complications. These findings support the incorporation of lymphadenectomy into standard surgical management for appropriately selected patients. Further research is needed to refine techniques and reduce associated risks.

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International Journal of Medical Arts

Articles in Press, Accepted Manuscript
Available Online from 16 April 2025

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