Because of the limited number of reports concerning the influence of retroperitoneal
lymph node metastasis upon survival in patients with ovarian
carcinoma, a prospective study was conducted between December 1975 and December 1982 to provide such information. This series consisted of 75 unselected patients with epithelial
carcinoma of the ovary in all stages. Thirty-three patients had
tumor-positive nodes and 42 had negative nodes. The two groups were compared with regard to stage of disease, grade of
tumor, histology of
tumor, residual disease after initial operation, finding at second-look
laparotomy, and survival. All had initial maximal surgery and biopsy of para-aortic and pelvic nodes: most received postoperative
chemotherapy. Follow-up was from 36 months to 10 years. Patients with positive nodes preferentially had more advanced disease (Stage III and IV). Grade 3
tumor, papillary
serous cystadenocarcinoma, residual disease greater than 2%, low rate of second-look
laparotomy, and death. Patients with negative nodes were connected with earlier disease (Stage I and II), nonserous
tumor,
minimal residual disease, high rate of second-look
laparotomy, and survival. No patient with isolated nodal
metastasis to pelvic or para-aortic survived. Only 18.2% with concomitant para-aortic and pelvic node involvements are currently alive, opposed to 64.3% with negative node. The results indicate that
tumor-positive nodes in ovarian
carcinoma are a poor prognostic factor and current
combination chemotherapy is not effective. Alternative treatment for these patients should be considered.