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Maximum Effort in the Management of Ovarian Cancer, Including Pelvic and Para‐aortic Lymphadenectomy
Author(s) -
Allen D. G.,
Planner R. S.,
Grant P. T.
Publication year - 1992
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1992.tb01899.x
Subject(s) - medicine , lymphadenectomy , ovarian cancer , general surgery , gynecology , oncology , radiology , cancer
EDITORIAL COMMENT : There is no doubt that the competent gynaecological oncologist has marvellous skill at removing tumour in women with Stages 3 or 4 ovarian cancer ‐ in the very type of patient regarded as inoperable 10–30 years ago by general gynaecologists. Present‐day general surgeons presumably have the skill, but apparently not the will, to remove tumour in women with metastatic bowel cancer, for reasons not clear to the editor. Is it established fact that removing as much tumour as possible is a waste of time in women with extensive peritoneal metastases from bowel cancer; or does the general surgeon have a different therapeutic philosophy because a high proportion of his patients with bowel cancer have early stage disease, a state of affairs not enjoyed by those who operate on women with carcinoma of the ovary? Readers must be patient and await the publication of the 2 to 5‐year results of treatment of women with ovarian cancer managed by members of this oncology unit in Melbourne. Summary Patients treated for ovarian cancer at the Mercy Hospital for Women, Melbourne over a 51/2 year period were studied with an emphasis on the need for lymphadenectomy. There were 80 patients identified with ovarian cancer. Forty patients underwent pelvic and/or para‐aortic lymphadenectomy and 25 (62.5%) were found to have lymph node metastases, in 7 of the 40 women the lymphadenectomy resulting in upstaging of the disease. FIGO has adopted a surgicopathological approach to the staging of ovarian cancer and this requires lymphadenectomy to be performed. The importance of accurate staging in clinically early ovarian cancer and maximum surgical effort in advanced disease is discussed with particular regard to the place of lymphadenectomy.