**1. Introduction**

Ovarian cancer represents a common malignancy affecting women worldwide that unfortunately remains asymptomatic for a long period of time; therefore, most cases are diagnosed in advanced stages of the disease, when dissemination through peritoneal, hematogenous or lymphatic routes is already present [1]. However, a limited number of cases will be diagnosed in presumed early stages of the disease. However, up to 15% of these cases prove to have positive lymph nodes, which will significantly influence the long-term prognosis [2]; in the meantime, routine performance of extended pelvic and para-aortic lymph node dissection in presumed early stage ovarian cancer will lead to an unnecessary surgical procedure in up to 80% of cases who have otherwise negative lymph

nodes [3–6]. Moreover, performing such procedures will increase the risk of developing perioperative complications, which might significantly influence the quality of life [7,8]. Therefore, identifying cases which present retroperitoneal para-aortic lymph node metastases will enable the oncologist to provide a better selection of cases that will benefit from adjuvant chemotherapy [2,3,9–11]. The aim of the current paper is to investigate the risk factors for developing para-aortic lymph node metastases in cases diagnosed with a presumed early stage of disease.
