Abstract
This study is done to evaluate whether it is necessary to do systematic retroperitoneal lymphadenectomy in all early-stage mucinous ovarian cancer (mOC) or do we need to change our routine practice according to new scientific clinical-based evidence. This is a single centre observational study where retrospective data of 81 patients of early stage mOC were prospectively analyzed into two groups depending on the systematic dissection of retroperitoneal lymph node i.e. 1. Lymph node dissection (LND+) group versus 2. Lymph node none-dissection (LND-) group. Log Rank (Mantle- Cox) test was used among these two groups to look for a comparison of outcome in terms of progression free survival (PFS) and overall survival (OS). During 2008-2016 out of 268 patients 123 had primary mOC and among them, 81 were early stage. Out of 81 patients, 48 were in LND+ and 33 patients in LND- group. The incidence of grade I mOC was 79.16% and 84.85% in LND+ and LND- group respectively. None of the LND+ cases came positive in the final report which shows very rare involvement of lymph nodes (LN)in early stage mOC. PFS was not statistically significant (p-value 0.061) in between the LND+(91.7%) and LND- (75.8%) groups. The same was true for a 5-year OS. There was no significant improvement of OS in between the LND+ (95.8%) and LND- (87.9%) groups. There was no lymph node recurrence even in LND- groups. This study has given us the insight that in early stage mOC routine systematic lymph node dissection (LND) can be omitted as it does not improve PFS and OS.
Keywords: Lymph Node Dissection, Mucinous Ovarian Cancer, Overall Survival, Progression Free Survival.