228 Predictive factors of lymph node involvement and topography of lymph node metastasis in patients with epithelial ovarian cancer

Objectives to determine the rate, the repartition and to predict the risk factors of lymph node metastasis in patients operated on for epithelial ovarian cancer. Methods we reviewed retrospectively the data of 185 patients diagnosed of epithelial ovarian cancer and operated on between January 2005 and October 2019 at Hotel-Dieu de France University Hospital. Results 88% of patients received a pelvic and paraaortic lymphadenectomy. Node involvement was noted in 56% of cases. 85% of patients presented lymph node metastasis in the pelvic lymph nodes and 83% in the paraaortic nodes. Lymph nodes metastases in both pelvic and paraaortic levels were encountered in 70% of cases. Isolated pelvic or aortic lymph node metastases were seen in 16% and 14% of cases respectively. The median number of removed pelvic and paraaortic lymph nodes was 27 and 30 nodes respectively. In the univariate analysis, the rate of positive lymph nodes was higher in patients with serous histology (65% (serous) vs. 33% (non-serous), p=0.000), high grade (68% vs. 26%, p=0.000), bilateral adnexal involvement (74% vs. 27%, p =0.000) and positive peritoneal cytology (79% vs. 26%, p=0.000). In multivariate logistic regression analysis, the rate was significantly higher in patients with bilateral adnexal involvement, higher grade and positive peritoneal cytology. Conclusion Serous histology, grade 3 tumors, positive peritoneal cytology and bilateral adnexal involvement seem to predictive factors of lymph node involvement in patients with ovarian cancers.