**The Role of Lymphadenectomy in Ovarian Epithelial Cancer Cancer**

**The Role of Lymphadenectomy in Ovarian Epithelial** 

DOI: 10.5772/intechopen.72702

#### Hans Nagar Hans Nagar Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.72702

#### **Abstract**

High-grade serous ovarian/tubal cancer commonly spreads via the peritoneal and lymphatic routes. This chapter discusses the anatomical lymphatic drainage of the ovary and tube with reference to spread from different epithelial ovarian cancer types. The role of lymph node surgery in apparent early stage curative disease will be discussed with reference to staging and directing the need for adjuvant chemotherapy. In advanced disease, the role of lymph node sampling versus systematic dissection surgery as part of cytoreduction is assessed. The result of two randomised controlled trials (RCTs) published on the subject will be analysed along with the ongoing Lymphadenectomy in Ovarian Neoplasia (LION) study. The chapter adopts an evidence-based approach to the role of lymph node surgery in women with epithelial ovarian/tubal cancer.

**Keywords:** epithelial ovarian/tubal cancer, high-grade serous, para aortic lymph node, pelvic lymph node, systematic dissection sampling, FIGO staging

#### **1. Introduction**

The modern of management of women with ovarian involves complete surgical cytoreduction of all visible disease [1]. It is therefore important to understand that approximately 70% of the women will also have lymphatic spread. Even in disease, apparently confined to one or both ovaries, there is evidence of nodal metastatic spread in up to 24% of women [2].

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons
