Lymph Nodes Overlooked in Ovarian Cancer Patients

Women with early-stage ovarian cancer were nearly twice as likely to die if they did not have recommended staging biopsies of pelvic and aortic lymph nodes, according to a study by UC Davis Cancer Center and California Cancer Registry researchers. More than a quarter of those cancer patients do not receive the biopsies that have been shown to improve survival rates, the study results found.

Particularly surprising was the disparity in treatment, according to senior study author Gary S. Leiserowitz, MD, chief of Gynecologic Oncology at UC Davis, Sacramento, California. Gynecologic oncologists were 6.5 times more likely to perform lymph node biopsies than other surgical specialists were and nearly 4 times more likely to carry out all recommended staging biopsies.

“The one message is that it would be to a patient’s advantage to see someone in gynecologic oncology who would be more likely to adhere to the staging guidelines,” he said.

Those published guidelines have been in place for decades, said Leiserowitz. In some ways, he said, the study results are a wakeup call. He said there might be a change in the practice pattern with oncologists either adhering to the guidelines or referring their ovarian cancer patients to those proficient in the procedures.

The study, coordinated by lead author Rosemary Cress, DrPH, an epidemiologist and the research program director at the California Cancer Registry, focused on 721 patients in California and New York. Cress identified patients with early-stage epithelial ovarian cancer between 1998 and 2000.

“This should raise the awareness among physicians that it’s really important to do lymph node biopsies in these patients,” said Cress.