Lymphocele following Cytoreductive Surgery and Hipec for locally Advanced Ovarian Cancer

Background and Aim: Lymphocele is a frequent complication of ovarian cancer. This study attempts to investigate the incidence of lymphocele after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: Clinical and pathologic variables were correlated to the formation of lymphocele in patients with ovarian cancer who underwent CRS in combination with HIPEC. Results: In 148 women treated with CRS plus HIPEC, giant lymphoceles were found in 20 patients (13.5%) and asymptomatic lymphoceles in 37 patients (25%). Lymphoceles were more frequently formed in patients a) with complete or near-complete cytoreduction (p=0.008), b) with abdomino-pelvic lymph node dissection (p=0.017), c) with a PCI=14- 20 (p=0.005), d) with infiltrated large bowel lymph nodes (p=0.026). The abdomino-pelvic lymph node dissection (p=0.017, 95% CI=0.205-0.854) and the infiltrated large bowel lymph nodes (p=0.027, 95% CI=0.222-0.912) were indicated as independent variables for lymphocele formation. Conclusions: The number of patients treated with CRS and HIPEC complicated with lymphocele formation does not appear to differ from the number of patients treated with conventional cytoreduction. The independent variables of lymphocele formation are the extent of lymph node resection and the infiltration of the resected large bowel lymph nodes.