GO-Simple

A Randomized Trial of Lymphadenectomy in Patients with Advanced Ovarian Neoplasms (LION Trial)

Type: Ovarian Cancer

Section: Medical therapy for ovarian cancer

Published: February 2019

This study aimed to determined whether removing normal normal appearing lymph nodes improved patient overall survival and progression-free survival in surgery for patients with newly diagnosed ovarian cancer.
Lymph nodes are a common site for cancer to spread in the body. However, the role of removing normal appearing lymph nodes in surgery for ovarian cancer has been questioned. This is due to the surgical risks involved in removing normal appearing lymph nodes and lack of evidence that exists in the literature for removing them.


Aim of the study

The aim of this study was to determine whether removing normal appearing lymph nodes improved patient overall survival and progression-free survival in surgery for patients with newly diagnosed ovarian cancer.


Trial description

Patients with newly diagnosed ovarian cancer who had a complete resection at primary surgery were randomly selected to either have their lymph nodes removed or not at the time of surgery. The study was conducted between 2007 and 2012, with a total of 647 patients included (323 had lymph nodes removed, 324 did not).


Outcome

The removal of normal looking lymph nodes at the time of primary surgery for ovarian cancer did not improve overall survival or progression free survival. Furthermore, patients who underwent the removal of normal lymph nodes as a part of the study were more likely to experience a serious complication in the first 60 days after surgery.


Conclusion

The removal of normal appearing lymph nodes during surgery for newly diagnosed ovarian cancer doesn’t improve survival. It is still recommended that enlarged lymph nodes should be removed to allow for complete resection.