Effect of lymph node dissection on overall and disease free survival in early epithelial ovarian cancer (EOC)

Objectives: The aim of this study was to evaluate the effect of systemic lymphatic dissection on overall and disease free survival in early epithlial ovarian cancer in our institute.
Introduction: Ovarian cancer is potentially curable by surgery; the cure rate is, however, poor because in most patients the disease is diagnosed at an advanced stage when overall five-year survival is only about 30%. Even when the tumor is seemingly limited to the gonads or with pelvic extension only the spread to retroperitoneal nodes is not uncommon. Retrospective study to assess the impact of lymphadenectomy on survival in patients with clinical stage I ovarian cancer and suggested that lymphadenectomy significantly improved the survival of such patients. Randomized study was conducted to investigate the effect of systematic lymphadenectomy in patients with pT1 and pT2 ovarian cancer, which showed that systematic lymphadenectomy had no influence on either progression free survival or overall survival.
Patients and methods: From December 2014 to January 2019 we collect date of one hundred and forty seven female patients with clinically FIGO stage I and II epithelial ovarian cancer underwent primary surgical treatment from a total of 520 patients with different stages of ovarian cancer that were admitted and operated at South Egypt Cancer Institute, Assiut University, Egypt.
Results: Mean age of patients in the study was 59.21 ± 10.121years with range 35 – 76 years. 44.2% of patients had comorbidities as diabetes, hypertension and others some patients may had more than one disease. Patients were ranged from 0 to two ECOG performance; most of patients had zero performance (51%). 60(40.8%) patients had received adjuvant chemotherapy. In our study overall survival and DFS was 74% and 68.7% respectively while mean time of survival and recurrence was 65.9456 ± 21.9450 with range of 36 – 120 months and 56.76 ± 23.927 with range of 10 – 120 months respectively.
Conclusion: Systemic lymphadenectomy even if have significant effect on DFS but it has multiple operative and post-operative morbidities and no significant effect on overall survival.