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Abstract The results of this large retrospective study of 328 ad- vanced ovarian cancer patients who had lymphadenectomy confirm and extend previous data reported by us and other authors. In fact, according to the literature, the rate of node involvement in untreated patients with advanced disease ranges from approximately 55 to 75% (Scarabelli et al., 2015; Spirtos et al., 2012). In our study, an overall positivity rate of 59.1% was found. It seems that lymph node metastases are more common in this disease than in other gynecologic cancers. Moreover, it has to be stressed that, in the present study, 20.6% of the patients had more than 10 positive nodes. As previously reported by Burghardt et al. the positivity rate and the number of metastatic nodes seem to be related to the intraperitoneal tumor spread and to the resectability of tumor masses. Not surprisingly, patients with Stage IIIB{u2013} C disease and with suboptimal residual tumor had a significantly higher rate of lymph node involvement than those with limited disease and no or minimal residual tumor. Likewise, a higher percentageof patients with worse prognostic factors were found to have more than 10 positive nodes.These observations confirm that there is a close relationship between intraperitoneal more spread and lymph node involvement |