Early-stage epithelial ovarian cancer: is systematic lymph node staging mandatory?

摘要

The indication for lymph node dissection (LND) in ovarian cancer patients has been a major topic of debate in the last decades. The recent prospective LION trial [1], demonstrated no outcome benefit of systematic LND in advanced disease with macroscopically complete resection and clinically normal lymph node (LN), and by that ended the debate in these cases. For early disease, things appear to be more complicated and data is conflicting. Maggioni et al. [2] showed some 20 years ago in a prospective randomized trial with the primary endpoint of positive LN, that they could be identified more often by systematic LND compared to LN sampling. Unfortunately, this trial was not powered for efficacy. Several large retrospective studies have demonstrated inconsistent results regarding the therapeutic potential of systematic LND in these cases.