Anatomy, Imaging, and Surgical Treatment of Thoracic Lymphadenopathies in Advanced Epithelial Ovarian Cancer.

Ovarian cancer typically presents at advanced stages, with prognosis heavily influenced by the presence of residual disease following cytoreductive surgery. The role of resecting enlarged extra-abdominal lymph nodes during cytoreductive procedures remains contentious. These enlarged lymph nodes are commonly identified through high-resolution imaging techniques such as ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT). A comprehensive understanding of the relevant anatomy, imaging modalities, and surgical techniques for addressing lymphadenopathy in regions such as the supraclavicular fossa, axillae, mediastinum, and pericardiophrenic fat is crucial in determining the feasibility of surgical intervention. An appropriate evaluation of these factors is essential to optimize debulking, which is recognized as the most significant prognostic determinant in patients with ovarian cancer. This review underscores the importance of multidisciplinary approaches in managing advanced ovarian cancer with extra-abdominal lymph node involvement to enhance patient outcomes.