Suprarenal lymphadenectomy with nephrectomy for refractory ovarian cancer.

The effect of debulking surgery is not vague in patients with refractory ovarian cancer because of drug-resistant tumor biology showing rapid growth. However, it can be considered to be beneficial for selected patients expected to show tumor response by postoperative treatment because the better perfused small tumors may favor the action of cytotoxic therapy. Among them, patients with enlarged lymph nodes and mutations can show a relatively high rate of response and improved survival by systematic lymphadenectomy followed by poly ADP ribose polymerase (PARP) inhibitors. However, the resection of enlarged lymph nodes above the renal vein may not be familiar to gynecologic oncologists, in particular, for patients who had undergone previous debulking surgery followed by repetitive chemotherapy. Thus, this video will show the step by step procedure of suprarenal lymphadenectomy and resection of kidney and suprahilar lymph nodes for complete resection of refractory ovarian cancer.