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CC BY-NC-ND 4.0 · South Asian J Cancer 2025; 14(03): 460-473
DOI: 10.1055/s-0044-1789581
Original Article
Gynaecology - Ovarian Section

Spectrum of Surgico-Pathological Factors and Lymph Node Metastasis among Epithelial Ovarian Cancers: Experience of a Single Tertiary Care Institution from India

Autor*innen

  • Anupama Bahadur

    1   Department of Obstetrics and Gynaecology, AIIMS Rishikesh, India

  • Pallavi Verma 

    2   Department of Obstetrics & Gynaecology (Gynaecologic Oncology), INHS Asvini Mumbai, India

  • Shalini Rajaram

    3   Department of Obstetrics & Gynaecology, Gynaecologic Oncology division of Obstetrics & Gynaecology, AIIMS Rishikesh, India

  • Jaya Chaturvedi

    1   Department of Obstetrics and Gynaecology, AIIMS Rishikesh, India

  • Rajkumar Kottayasamy Seenivasagam

    4   Department of Surgical Oncology, PSG Institute of Medical Sciences and Research, Coimbatore, India

  • Rajlaxmi Mundhra

    1   Department of Obstetrics and Gynaecology, AIIMS Rishikesh, India

  • Amrita Gaurav 

    1   Department of Obstetrics and Gynaecology, AIIMS Rishikesh, India

  • Shalinee Rao

    5   Department of Pathology, AIIMS Rishikesh, India

  • Shilpa Panta

    1   Department of Obstetrics and Gynaecology, AIIMS Rishikesh, India

  • Sandipan Chowdhuri

    6   Department of Gynaecologic Oncology, Saroj Gupta Cancer Centre & Research Institute, India
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Abstract

Introduction Epithelial ovarian cancer (EOC) is one of the leading causes of mortality among women worldwide. The present study aimed to estimate the frequency of various histopathological types, clinical and surgico-pathological factors, and spectrum of lymph node (LN) metastasis in early and advanced EOC.

Material and Methods Women with EOCs who underwent cytoreductive surgery (CRS) between January 2019 and May 2022 were included. The distribution of Clinico-demographic parameters, histological type, stage, and LN metastasis were analyzed.

Results A total of 101 women with EOCs underwent CRS, out of which 5 (4.95%) with coexistent endometrial cancer were excluded (N = 96). Fifty women (52%) underwent primary CRS and 46 (48%) women underwent interval CRS. The mean age of the women was 48.42 ± 11.6 years. Initial serum cancer antigen 125 (CA 125) level was elevated (>35 U/mL) in 88 (91.67%) women and normal in 8 (8.33%) women. Complete cytoreduction was achieved in 75 (78.12%) cases. High-grade serous carcinoma was the most common histology (66/96, 68.75%), followed by mucinous carcinoma (15/96, 15.63%), endometrioid carcinoma (6/96, 6.25%), low-grade serous carcinoma (4/96, 4.17%), and carcinosarcoma (2/96, 2.08%). The majority of women, 69 (71.88%), were in stages III and IV at presentation. Most serous carcinomas were diagnosed at stage III (71.22%) or IV (13.64%). In contrast, the majority of endometrioid, mucinous, and clear cell carcinomas were diagnosed at stages I and II. Seventy-five women (78.13%) with EOC underwent pelvic and/or para-aortic lymphadenectomy, out of which 23 (30.67%) were histologically positive. Three out of 23 patients (13%) with early-stage disease showed positive LNs.

Conclusion Serous carcinoma ovary is the most common histological subtype, presenting mostly in the advanced stage. A significant number of affected women were younger at presentation and diagnosis was made a decade earlier than the western population. A systematic pelvic and para-aortic lymphadenectomy in apparently early-stage (pelvic confined) ovarian cancer could detect additional LNs in 13% of women, especially in high-grade tumors and serous histology, suggesting the role of systematic lymphadenectomy for accurate staging in apparently early-stage ovarian cancer.

Keywords

cytoreductive surgery - epithelial ovarian cancer - lymph node metastasis - ovarian cancer - surgico-pathologic factors

Supplementary Material



Publikationsverlauf

Eingereicht: 26. Dezember 2023

Angenommen: 29. Juli 2024

Artikel online veröffentlicht:
27. August 2024

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