By which two lymph node routes does ovarian cancer spread most often?

Ovarian cancer typically spreads through specific lymph node pathways, with the para-aortic and pelvic lymph nodes being the most common routes. The para-aortic lymph nodes are situated along the aorta in the abdomen and receive lymphatic drainage from the ovaries, making them a primary site for metastasis. Additionally, the pelvic lymph nodes are also involved due to their proximity to the ovaries and are frequently affected when the cancer invades surrounding structures.

Choosing the para-aortic and pelvic routes as the main pathways reflects an understanding of the typical progression of ovarian cancer, where cancerous cells travel through the lymphatic system to these key nodal areas. This route is significant in understanding the staging and treatment strategies for ovarian cancer, influencing decisions regarding surgical intervention and lymphadenectomy, as well as the overall prognosis of the disease.

Other routes, such as abdominal and cervical, may be involved in cancer spread but are less commonly noted pathways for ovarian cancer specifically. The internal and external iliac routes are more closely associated with lower reproductive organ cancers. Therefore, the identification of para-aortic and pelvic lymph nodes as the primary spread pathways aligns with the established patterns in oncology regarding ovarian cancer.