Giuseppe Caruso, Gynecology Oncology Specialist at European Institute of Oncology, shared on LinkedIn:
“For those like me who still feel there are several grey zones in the recommendations on systematic lymph node dissection (syLND) in apparent early-stage EOC, this is another interesting piece of evidence reminding us that the risk of occult nodal metastases – and therefore upstaging due to nodal disease alone – may not be as low as we sometimes assume in LGSOC.
We are talking about ~10%. One woman out of 10.
Personally, I would not feel entirely comfortable omitting syLND in all patients with presumed early-stage LGSOC.
I believe there is still room for individualized preoperative counselling and shared decision-making, particularly in an era of rapidly evolving systemic treatments for advanced disease, including for less common histotypes.
The new ESGO guidelines presented at ESGO 2026 in Copenaghen state that syLND is not recommended in LGSOC – and I fully respect the expert opinion and the recommendation.
But are we really sure? Thoughts?”
Title: Frequency of lymph node involvement in clinically early-stage low-grade serous ovarian cancer: a systematic review and meta-analysis
Authors: David Viveros-Carreño, Nuria Agustí, Nathalia Mora-Soto, Isabel Beshar, Martina Aida Angeles, Juliana Rodríguez, Kate J. Krause, Maria D. Iniesta, Roni Nitecki Wilke, Alexander Melamed, J Alejandro Rauh-Hain, René Pareja
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