Transdiaphragmatic Cardiophrenic Lymph Node Dissection in Advanced Epithelial Ovarian Cancer: Surgical Results and Clinical Safety from a Single Institution

Background The dissemination of cancer to the cardiophrenic lymph nodes (CPLN) has been recognized as a significant marker of extensive pathology in the upper abdominal region in individuals diagnosed with advanced epithelial ovarian cancer (EOC).However, there is limited documentation regarding the technical success and safety profiles of transdiaphragmatic cardiophrenic lymph node dissection (CPLND) in this patient population. Methods This study analyzed 15 patients who underwent CPLND during primary cytoreductive surgery for advanced EOC at Etlik City Hospital, Ankara, Türkiye, between December 2022 and April 2025. A transdiaphragmatic approach was employed for all operative procedures. Demographic characteristics, surgical parameters, and postoperative outcomes were comprehensive descriptive statistical evaluation. Results The demographic characteristics of the patient population showed a mean age of 63.2 ± 8.8 years, as well as an average body mass index (BMI) of 28.2 ± 3.4 kg/m². The presence of Stage III–IV EOC was noted in 80% of participants, with serous carcinoma forming the primary histological subtype at 73.3%. CPLNs showed an average diameter measuring 14.2 ± 3.4 mm, with every lymph node identified situated on the right side. Complete macroscopic tumour resection (R0 resection) was achieved in 66.7% of the cases. The operative duration was averaged at 325 ± 78 minutes, and the blood loss noted during the procedure was about 480 ± 220 mL. 66.7% of patients needed chest tube insertion, with the tubes staying in for an average of 4 days, give or take 2. Postoperative complications encompassed pleural effusion or atelectasis in 53.3% of the cases, and infectious complications or fever were observed in 33.3%. No perioperative mortality was documented. Conclusion In patients with advanced epithelial ovarian cancer (EOC), performing cardiophrenic lymph node (CPLN) dissection through the diaphragm is both safe and practically achievable as part of comprehensive cytoreductive surgery. The procedure's safety is evidenced by the conservative management of most respiratory complications, indicating tolerable morbidity rates for this patient group.