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Pathological Diagnosis and Cytoreduction of Cardiophrenic Lymph Node and Pleural Metastasis in Ovarian Cancer Patients Using Video-Assisted Thoracic Surgery

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to assess the benefit of video-assisted thoracic surgery (VATS) in pathological diagnosis and intrathoracic cytoreduction of cardiophrenic lymph node (CPLN) and pleural metastasis on computed tomography (CT) in patients with ovarian cancer.

Methods

We reviewed a database of ovarian cancer patients who underwent VATS from June 2007 to November 2008. The criterion for suspicion of malignancy on CT was either a CPLN with short-axis dimension >5 mm or multinodular pleural thickening. Seven patients with primary ovarian cancer and five patients with recurrent ovarian cancer were identified and evaluated.

Results

Twelve patients met the criterion for suspicious malignancy on CT, with CPLN metastasis and pleural metastasis in nine and five patients, respectively. CPLN metastasis was identified in two of four patients with primary ovarian cancer and in all five patients with recurrent ovarian cancer who had CPLN >5 mm on CT. Pleural metastasis was identified in three of five patients with suspicious pleural metastasis and in one of seven patients without suspicious pleural metastasis on preoperative CT. The median operation time for VATS was 65 min and estimated blood loss was less than 20 ml in all cases. All visible intrathoracic diseases were completely resected without major complications, and VATS did not delay planned treatment.

Conclusion

VATS enables the accurate pathological diagnosis and intrathoracic resection of pleural and CPLN metastasis in patients with ovarian cancer with acceptable morbidity. Further studies are needed to confirm the impact of VATS on survival in patients with ovarian cancer.

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Acknowledgment

The authors would like to thank all anesthesiologists and surgery nurses at the Center for Uterine Cancer and Center for Lung Cancer for their invaluable help, patience, and active participation in performing this study. The authors also would like to thank Su-Hang Jo and Mi-Jung Lee, research nurses at the National Cancer Center, Korea, for their efforts in gathering and organizing the data. This work was supported by grants from the Korean National Cancer Center (0710200-2 and 0710210-2) and by a graduate research scholarship from Kyung Hee University, Seoul, Korea.

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Authors and Affiliations

  1. Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 111 Jungbalsan, Ilsandong, Goyang, Gyeonggi, Korea

    Myong Cheol Lim MD, Ji Young Choi MD, Sang-Soo Seo PhD & Sang-Yoon Park MD, PhD

  2. Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, 111 Jungbalsan, Ilsandong, Goyang, Gyeonggi, Korea

    Hyun-Sung Lee PhD

  3. Department of Radiology, Research Institute and Hospital, National Cancer Center, 111 Jungbalsan, Ilsandong, Goyang, Gyeonggi, Korea

    Dae Chul Jung PhD

  4. Department of Obstetrics and Gynecology, Kyung Hee University, San-1 beongi, Hoegi-dong, Dongdaemoon, Seoul, Korea

    Myong Cheol Lim MD

  5. Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea

    Ji Young Choi MD

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  1. Myong Cheol Lim MD
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  2. Hyun-Sung Lee PhD
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  3. Dae Chul Jung PhD
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  6. Sang-Yoon Park MD, PhD
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Corresponding author

Correspondence to Sang-Yoon Park MD, PhD.

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Lim, M.C., Lee, HS., Jung, D.C. et al. Pathological Diagnosis and Cytoreduction of Cardiophrenic Lymph Node and Pleural Metastasis in Ovarian Cancer Patients Using Video-Assisted Thoracic Surgery. Ann Surg Oncol 16, 1990–1996 (2009). https://doi.org/10.1245/s10434-009-0486-5

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  • DOI: https://doi.org/10.1245/s10434-009-0486-5

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