The following is the summary of “Upfront surgery in patients with epithelial ovarian cancer and enlarged supradiaphragmatic lymph nodes associated with comparable to neoadjuvant chemotherapy” published in the December 2022 issue of Women’s health by Weitzner, et al.

The optimum treatment for advanced epithelial ovarian cancer (EOC) in patients with isolated extra-peritoneal disease in the cardiophrenic lymph nodes is not well understood due to a lack of available data. The purpose of this study was to determine whether the therapy method these patients received had any impact on their prognosis or surgical outcomes. Patients diagnosed with advanced EOC and who received treatment between 2012 and 2020 were included in this retrospective cohort analysis. The patient’s CT scans were analyzed to determine the disease’s severity and whether or not enlarged supradiaphragmatic lymph nodes (SDLN) were present. The following types of data were recorded: demographic, clinical, and oncologic. 

Patients with and without an expanded SDLN were analyzed for their characteristics and outcomes, and the outcomes of patients with an enlarged SDLN who underwent upfront surgery and neoadjuvant chemotherapy were compared. Out of 71 women, 47 had enlarged supradiaphragmatic lymph nodes, which is a 66% prevalence rate. The groups all shared comparable traits at the beginning. A total of 47 women were found to have an increased SDLN. There was no discernible difference in progression-free survival between patients who had upfront cytoreduction and those who got neoadjuvant chemotherapy. 

Patients who had upfront cytoreduction had the same rate of progression-free survival. There was only one instance of asymptomatic chest cancer returning after treatment. Patients who have an enlarged SDLN have similar results regardless of whether they undergo upfront surgery or neoadjuvant chemotherapy. In addition, the incidence of chest recurrences in patients who report an enlarged SDLN is extremely uncommon.