Document Type : Original Article
Authors
1
Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
2
Department of Surgical Oncology, Tehran University of Medical sciences, Tehran, Iran
3
Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
4
Department of Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
5
Department of Surgical Oncology, Tehran University of Medical sciences, Tehran, Iran AND Breast Diseases Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background and Aims: Systematic lymphadenectomy remains integral to the surgical staging of ovarian cancer, yet the procedure carries considerable risk of morbidity. Refining the criteria for lymph node dissection by identifying robust preoperative predictors of metastasis could spare low-risk patients from these associated complications.
Methods: In this cross-sectional analysis, we reviewed 66 consecutive cases of epithelial ovarian cancer treated at two tertiary care centers in Tehran from 2019 to 2021. Preoperative clinical, imaging, and serological parameters were documented. All patients underwent comprehensive surgical staging, including lymphadenectomy. Associations between clinicopathological variables and lymph node metastasis were evaluated using chi-square tests, with multivariate logistic regression employed to define independent predictors.
Results: Lymph node involvement was present in 26 patients (39.4%). Univariate analysis identified significant correlations between nodal metastasis and younger age (≤50 years), bilateral adnexal involvement, serous histology, grade 3 differentiation, and International Federation of Gynecology and Obstetrics (FIGO) stage 3 disease. On multivariate analysis, each factor retained independent predictive value: age ≤50 years (odds ratio [OR] 3.07, 95% CI 1.02–9.24), bilateral tumors (OR 2.56, 95% CI 0.94–6.95), serous histology (OR 4.38, 95% CI 1.41–13.58), grade 3 (OR 14.25, 95% CI 4.12–49.30), and stage 3 (OR 20.09, 95% CI 5.87–68.79).
Conclusion: Our findings confirm that a distinct profile -characterized by younger age, bilaterality, serous histotype, high-grade differentiation, and advanced stage- significantly elevates the risk of lymphatic spread in ovarian carcinoma. Consequently, lymphadenectomy might be safely deferred in a carefully selected subset of patients with opposing low-risk features: age >50 years, unilateral, mucinous, grade 1 tumors confined to stage I. This selective approach could mitigate surgical morbidity while preserving oncologic safety.
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