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Current Status of Metastatic Cardiophrenic Lymph Nodes (CPLNs) in Patients With Ovarian Cancer: A Review

Background: One of the most common sites of extra-abdominal disease spread of advanced stage ovarian cancer is the cardiophrenic lymph node (CPLN) region. The role and impact of extra-abdominal cytoreduction is not obvious in patients with cardiophrenic lymph node metastases. Materials and Methods: We examined the relevant and currently available literature to determine the prognostic value and management of enlarged CPLNs in ovarian cancer patients. Results: Transdiaphragmatic excision of CPLNs or via video-assisted thoracoscopic surgery (VATS) is achievable without major complications. The most common postoperative complications were pleural effusion, pneumothorax and pneumonia. On preoperative CT scan, the cut-off size of suspicious CPLNs is not uniform and is indicated as 5 to 10 mm short-axis dimension. Conclusion: CPLNs were detected in up to 60% of patients and malignancy was pathologically confirmed in 45-95% of the cases. The presence of enlarged CPLNs was found to be a negative prognostic factor, although its impact on progression-free and overall survival is not yet clarified and needs further investigation.