Relationship between pelvic lymph node involvement and other disease sites in patients with ovarian cancer

In 109 patients with epithelial ovarian cancer, 25 (23%) had pelvic lymph node (PLN) metastasis. Positive rates of PLN metastasis according to the clinical stage based on disease distribution except retroperitoneal lymph node were 2% for stage I, 6% for stage II, 44% for stage III, and 64% for stage IV. The nine disease sites, such as subdiaphragmatic surface, liver and spleen capsule, intestine and mesentery, omentum, pelvic peritoneum, sigmoid colon and rectum, uterus and tubes, peritoneal cytology, and para-aortic lymph node (PAN), were found to have a statistically significant relationship with PLN metastasis by univariate analysis. Multivariate analysis using a logistic regression model selected the omentum and PAN as independent factors with a statistical significance. The incidence of PLN metastasis in epithelial ovarian cancer with the above two parameters can be assumed to be greater than that without the two parameters by 42.6 times. The present data suggested that for the disease with PAN and/or omental metastasis, removal of the PLN may be mandatory from the standpoint of cytoreduction.