Retroperitoneal metastases from ovarian carcinoma: reassessment of 365 patients studied with lymphography.

From 1973 through 1978, 365 patients with ovarian carcinoma were evaluated with lymphography. The extent of disease was assessed by clinical and conventional radiologic examinations, peritoneoscopy with visualization of diaphragmatic leaves, peritoneal cytology, and, in some patients, exploratory laparotomy. The highest incidence of metastases was found in advanced stages (31.1% in stage III and 60% in stage IV) and in recurrences (75.9%). In 87 patients with early disease, the incidence was 9.2%. In 36 pretreated patients with no evidence of disease, this incidence was 11.1%. Biopsies of the nodes were performed in 96 patients: radiologic accuracy was confirmed in 33 of 33 positive and in 55 of 63 negative cases. Of the patients, 33% had metastases only in the pelvic nodes, and 7.9% only in the paraaortic nodes; in 79.1%, both chains were involved simultaneously. These data confirm the importance of lymphography in diagnosis, treatment planning, and surveillance of ovarian carcinoma.