[A clinical study on the incidence of retroperitoneal lymph node metastasis and its risk factors in ovarian cancer].
OBJECTIVE: To investigate the incidence and the significant risk factors of retroperitoneal lymph node metastasis (LNM) in primary ovarian cancer for considering the necessity of systematic lymphadenectomy. METHODS: 117 cases of retroperitoneal lymphadenectomy performed on primary ovarian cancers in our hospital from November, 1987 to January, 1994 were studied. The relationship between clinicopathologic characters and the incidence of LNM were determined by univariate and multivariate analysis. RESULTS: In 44 (37.6%) of the 117 patients studied, LNM was confirmed pathologically. The chances of pelvic LNM (29.9%) were smilar to that of para-aortic LNM (20.9%) (P > 0.05). Univariate analysis showed that significantly increased incidence of LNM was clinically associated with bilateral involvement of the ovaries, presence of ascites, advanced stages, poor tumor differentiation, rather large residual tumors and some histopathological subtypes such as undifferentiated and serous adenocarcinoma. The size of the residual tumor, clinical stage and grade of differentiation were the most important risk factors for LNM (P < 0.05) by multivariate analysis. The indication, optimum time, the scope and model of systematic lymphadenectomy were evaluated and discussed. CONCLUSION: systematic lymphadenectomy was suggested only for early cases with high risk factors. For late cases with residual tumor the operation may be done at a chosen time, for instance, at second cytoreductive or second-look surgery.