The value of cytoreductive surgery for isolated lymph node recurrence of ovarian cancer

The purpose of the study was to undertake a systematic literature review regarding the role of cytoreductive surgery in treatment of recurrent ovarian cancer, as well as to summarize available data on various current studies and estimate indications for secondary cytoreduction in recurrent ovarian cancer with isolated lymph node involvement. Material and Methods. The search for relevant sources was carried out in PubMed, Gynecol Oncol, Medline, NCCN, Elibrary systems; publications were included from January 2006 up to March 2019. Of the 87 studies found, 26 were used to write a systematic review. Results. Ovarian cancer (OC) remains the leading cause of death from gynecological cancer. The initial treatment for IC-IV stages of OC includes surgical cytoreduction followed by platinum-containing chemotherapy. The best outcomes are observed in patients, in whom complete cytoreduction has been achieved. Despite this fact, most patients develop relapses and the 5-year survival rate is about 30 %. The frequency of lymph node involvement in patients with recurrent OC is not reliably known; isolated lymph node recurrence is reported to occur in 5-32 % of patients. To date, the problem regarding the extent of lymph node dissection in treatment of OC recurrence is still unsolved. In our paper we review the available data concerning the role of secondary cytoreductive surgery for isolated lymph node recurrence of ovarian cancer. Conclusion. Isolated lymph node recurrence of ovarian cancer may indicate a more favorable prognosis and has a less aggressive pattern of OC relapse. The role of secondary cytoreduction in this context is not fully understood, but this category of patients may be one of the most suitable for surgical treatment of ovarian cancer recurrence.