Incidence and impact of low-volume lymph node metastasis in apparent early-stage ovarian cancer: MICR-OVARY study

Objective Sentinel lymph node (SLN) biopsy is an emerging technique in apparent early-stage ovarian cancer, with potential to detect low. volume lymph node metastases. However, the prognostic value of low volume metastases is still unknown. This study aimed to assess the incidence and the prognosis of low volume metastases detected in apparent early-stage ovarian cancer patients undergoing SLN biopsy as part of a clinical trial. Methods Retrospective, multicenter, international study. Inclusion criteria were apparent FIGO 2014 stage I-II epithelial ovarian cancer, undergoing SLN biopsy with systematic bilateral pelvic and para-aortic lymphadenectomy, and complete peritoneal surgical staging, from October 2012 to December 2023. In the absence of lymph-node macro-metastasis, at least 4 level ultrastaging at SLN was performed. Fertility sparing surgery or no SLN detection were exclusion criteria. Low volume metastases were defined as any tumor deposit ≤2 mm (isolated tumor cells as