Incidence and pathways of retroperitoneal lymph node metastases in epithelial ovarian cencer.

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We investigated the incidence and the location of retroperitoneal lymph node metastases in 10 patients with ovarian carcinomas having undergone retroperitoneal lymphadenectomy.<BR>The incidence of retroperitoneal lymph node metastases was as follows : 0/2 in Stage Ic, 1/1 in Stage IIc, 5/6 in Stage IIIc, and 1/1 in Stage IV; 4/6 in serous cystadenocarcinomas and 3/4 in endometrioid carcinomas.<BR>Three patients were found to have solitary para-aortic nodal metastasis limited to the level below the inferior mesenteric artery (IMA). The remainings with nodal involvement had positive paraaortic nodes mostly beyond the level of IMA and/or positive pelvic nodes, possibly resulted from tumor dissemination in the broad ligament.<BR>Therefore, it is suggested that there is a route of lymphatic metastasis to para-aortic nodes whereby lymphatic spreading may occur primarily in the infra-IMA nodes via lymph channels running along ovarian vessels and subsequently spread cephalad. The pathways of retroperitoneal lymph node metastases, especially the routes of para-aortic lymph node metastasis, in epithelial ovarian carcinomas are discussed.
近畿産科婦人科学会の論文