**The Risk of Para-Aortic Lymph Node Metastases in Apparent Early Stage Ovarian Cancer**

**Nicolae Bacalbasa 1,2,3,**†**, Irina Balescu 1,4,\*, Mihaela Vilcu 1,5, Simona Dima 3, Camelia Diaconu 1,6,**†**, Laura Iliescu 1,7,**†**, Alexandru Filipescu 1,8,**†**, Mihai Dimitriu 1,9 and Iulian Brezean 1,6**


Received: 19 January 2020; Accepted: 21 February 2020; Published: 3 March 2020

**Abstract:** *Background and objectives:* To identify the risk factors for para-aortic lymph node metastases in cases with presumed early stage ovarian cancer. *Materials and methods*: Between 2014 and 2019, 48 patients with apparent early stage ovarian cancer were submitted to surgery. In all cases, pelvic and para-aortic lymph node dissection was performed for staging purposes. *Results*: Among the 48 cases we identified nine cases with positive pelvic lymph nodes and 11 cases with positive para-aortic lymph nodes. The positivity of the retrieved lymph nodes was significantly correlated with the histopathological subtype represented by serous histology (*p* = 0.02), as well as with the degree of differentiation (*p* = 0.004). *Conclusions*: Patients with serous ovarian carcinomas in association with a poorer degree of differentiation are at risk of associated lymph node metastases even in presumed early stages of the disease. Therefore, lymph node dissection should be performed in such cases in order to provide adequate staging and tailoring of further treatment.

**Keywords:** early stage; ovarian cancer; para-aortic lymph node metastases
