ArticleGynecologic oncology reports2025
Combined imaging and surgical predictors of cardiophrenic lymph node metastasis in ovarian cancer patients undergoing upfront surgery.
Article in Gynecologic oncology reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: The aim of this study was to identify preoperative and intraoperative factors associated with cardiophrenic lymph node (CPLN) metastasis and to evaluate their potential role in surgical decision-making in patients undergoing upfront surgery for ovarian cancer. Because unsuspected CPLN involvement can compromise the ability to achieve no gross residual disease, early identification may guide surgical planning and selection of candidates for CPLN dissection. Methods: From 2010 to 2023, electronic medical records of patients with upfront cytoreductive surgery including cardiophrenic lymph node (CPLN) dissection were reviewed and retrospectively analyzed. Results: A total of 165 patients underwent upfront cytoreductive surgery, including CPLN dissection, and 100 patients (60.6 %) were confirmed CPLN metastasis. Patients with CPLN metastasis showed a larger short-axis diameter on CT than those without CPLN metastasis (7.95 mm and 6.8 mm, p < 0.0001, respectively) and the best predictive cutoff value for short-axis length was 7.7 mm. (sensitivity 0.600 and specificity 0.754) In multivariate analysis, seeding on the diaphragm was associated with CPLN metastasis (p < 0.0001), and intra-abdominal residual disease was associated with CPLN metastasis (p = 0.0029). Conclusion: This study suggested preoperative and intraoperative factors associated with CPLN metastasis in ovarian cancer, including short-axis diameter, diaphragmatic involvement, and residual disease. While each factor has limitations as a standalone predictor, their combined assessment may provide useful guidance for surgical evaluation and planning in selected patients.
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