Ovarian neoplasms, or ovarian tumors, are benign or malignant tumors arising from the ovary. In patients with advanced ovarian cancer, systematic pelvic and paraaortic lymphadenectomy has been routinely used, albeit the efficacy of the treatment has not been well documented. This study aims to investigate the safety and efficacy of lymphadenectomy in patients with advanced ovarian cancer.

This randomized trial included a total of 647 patients with newly diagnosed advanced ovarian (stage IIB through IV) who had undergone macroscopically complete resection. The participants were randomly assigned in a 1:1 ration to undergo lymphadenectomy (n=323) or not undergo lymphadenectomy (n=324). The primary outcomes of the study were removed nodes, overall survival, and adverse events.

The median number of removed nodes among patients who underwent lymphadenectomy was 57, including 35 pelvic and 22 paraaortic nodes. The median overall survival in the lymphadenectomy group was 69.2 groups, as compared with 65.5 months in the non-lymphadenectomy group. The median progression-free survival in both the lymphadenectomy and non-lymphadenectomy groups was 25.5 months. Treatment-related adverse events, including repeat laparotomy and mortality, were more frequent in the lymphadenectomy group.

The findings suggested that systematic pelvic and paraaortic lymphadenectomy was not associated with longer progression-free survival than no-lymphadenectomy in patients with advanced ovarian cancer.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa1808424