TITLE:
Effectiveness of intraoperative ultrasonography for para-aortic lymph nodes in preventing unnecessary lymphadenectomy in ovarian carcinoma
AUTHORS:
Eiji Ryo, Tsunekazu Kita, Toshiharu Yasugi, Katsumi Mizutani, Michiharu Seto, Shigeki Takeshita, Takuya Ayabe
KEYWORDS:
Intraoperative Ultrasonography; Lymphadenectomy; Lymph Node; Lymph Node Metastases; Ovarian Carcinoma; Para-Aortic; Ultrasound
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.3 No.5A,
July
8,
2013
ABSTRACT:
Objective: To evaluate the usefulness of intraoperative ultrasonography (IU) for para-aortic nodes to identify women who do not require pelvic and paraaortic lymphadenectomy in ovarian carcinoma. Methods: Computed tomography (CT) was used for assessing both pelvic and para-aortic lymph nodes, and IU only for para-aortic nodes in 87 women with ovarian carcinoma. All women underwent surgery with routine systematic pelvic and para-aortic lymphadenectomy. We assumed that no lymphadenectomy had been performed when no enlarged node was detected by either CT or IU or when the woman was in T1 stage. Under these assumptions, the numbers of women who would have had missed metastases and who could have avoided lymphadenectomy were counted. These figures were recounted on the combination of T stage and IU. Results: A total of 22 women had pathological node metastases. The numbers of women with missed metastases on the basis of CT, IU, and T stage were 12, 2, 5, and these who could have avoided lymphadenectomy were 72, 39, and 49, respectively. There were more women avoiding lymphadenectomy by CT than IU and T stage; however, more women with missed node metastases. Both numbers were not significantly different between IU and T stage. On the combination of T stage and IU, 29 of 49 women in T1 stage could have avoided lymphadenectomy without missed metastases. Conclusions: IU for the para-aortic node is a useful method for identifying women who do not require lymphadenectomy for T1 stage ovarian carcinoma.