The aim of the study was to analyze the incidence of mesenteric lymph node metastases in patients with advanced-stage ovarian carcinoma to understand the potential biologic behavior of tumor spread. We retrospectively reviewed the medical records of all patients undergoing primary cytoreductive surgery and rectosigmoid resection for epithelial ovarian cancer from October 1997 through March 2010. Patients with pathologic documentation of mesenteric lymph nodes were selected for further review. χ2 analysis was used to identify clinicopathologic factors associated with mesenteric lymphatic spread.
We found a total of 120 patients in whom mesenteric lymph nodes were isolated by our pathologist. The median age was 57 years (range: 22-77). The median number of mesenteric nodes was eight (range: 1-37). Eighty-seven out of 120 (72%) cases had one or more mesenteric lymph node metastases, whereas 33 out of 120 (28%) were negative.
Among patients with metastasis to mesenteric lymph nodes the only serosal or subserosal involvement was present in 31 of 87 (36%) patients; 31 of 87 (36%) had invasion into the muscolaris propria, 19 of 87 (22%) had invasion into the submucosa, and six of 87 (6%) presented with full-thickness invasion of the bowel wall. Our results showed that lymph nodes are commonly involved in the main basins draining from the different tumor locations. Therefore, when ovarian carcinoma involves the rectosigmoid colon, metastases to mesenteric lymph nodes are as common as those to the pelvic and paraaortic nodes.
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