Evaluation of paraaortic lymph node metastasis in patients with primary epithelial carcinoma of the ovary

From 1979-1986, 110 patients with an ovarian cancer have been treated at Kyushu University Hospital. Sixty-eight of these patients with untreated primary adenocarcinoma of the ovary underwent a paraaortic lymph node (PAN) biopsy at the time of their initial surgery. Twenty-two of these 68 patients were found (32.4%) to have a positive PAN. Microscopic PAN metastases were present in 4 patients, who, macroscopically, seemed to have the disease confined to the pelvis. The incidence of a positive PAN was seen to correlate with the clinical stage and degree of differentiation of the primary tumor. Positive PANs were more frequent in cases of a serous rather than a mucinous carcinoma. All 5 patients with a metastatic adenocarcinoma originating from the stomach or the colon had a positive PAN. It thus has been concluded that a PAN evaluation is important for the management of ovarian cancer.