J Cancer 2016; 7(15):2241-2246. doi:10.7150/jca.15644 This issue Cite

Research Paper

Incidence and Impact of Lymph Node Metastases in Advanced Ovarian Cancer: Implications for Surgical Treatment

Cornelia Bachmann1✉, Robert Bachmann2, Falko Fend3, Diethelm Wallwiener1

1. Department of gynecology, University Tübingen, Calwer Str. 7, 72070 Tübingen, Germany;
2. Department of General, Visceral and Transplantation Surgery, University of Tübingen, Hoppe-Seyler Str. 3, 72076 Tübingen, Germany;
3. Department of Pathology, University Tübingen; Liebermeisterstraße 8; 72076Tübingen; Germany.

Citation:
Bachmann C, Bachmann R, Fend F, Wallwiener D. Incidence and Impact of Lymph Node Metastases in Advanced Ovarian Cancer: Implications for Surgical Treatment. J Cancer 2016; 7(15):2241-2246. doi:10.7150/jca.15644. https://www.jcancer.org/v07p2241.htm
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Abstract

Background: This study aimed to clarify the impact of node involvement (affected to resected nodes) in optimally cytoreduced (residual tumour ≤1cm) stage IIIC/IV ovarian cancer.

Methods: 108 consecutive patients with primary stage IIIC/IV ovarian cancer underwent stage-related surgery and got adjuvant platinum-based chemotherapy. Median follow-up: 53.5 months. All patients got systematic para-aortic and pelvic lymphadenectomy. Clinical parameters were retrospectively evaluated. Patients were stratified into 3 groups to evaluate node affection: 1) no (0%), 2) minor (>0%, ≤50%) >0 and 3) major (>50% of affected nodes). Kaplan-Meier survival curve was used to evaluate the prognostic value.

Results: On average, 21.3 pelvic and para-aortic nodes were removed per patient (range 1-60 nodes). Minor nodal involvement (node ratio >0-≤0.5: (59%) was most often detected. Increasing node ratio leads to significant decreased overall survival (p<0.001). Significant best overall survival was associated with minor node involvement (node ratio >0 to ≤0.5). Complete cytoreduction correlated with node affection shows significant best prognostic impact in minor node affection compared to incomplete resection (R>0-≤1cm) independent to nodal status (OS p<0.001).

Conclusion: Radical surgery is the main factor of improved overall and tumor free survival. Paraaortal and iliacal lymphadenectomy seems to play an important role for prognostic and therapeutic reasons: Prognostic in accurate staging and therapeutic in case of achieved optimal cytoreduction including lymph nodes with histology proven minor node involvement.

Keywords: Advanced ovarian cancer, node ratio, lymphadenectomy, prognosis, residual tumour, node involvement.


Citation styles

APA
Bachmann, C., Bachmann, R., Fend, F., Wallwiener, D. (2016). Incidence and Impact of Lymph Node Metastases in Advanced Ovarian Cancer: Implications for Surgical Treatment. Journal of Cancer, 7(15), 2241-2246. https://doi.org/10.7150/jca.15644.

ACS
Bachmann, C.; Bachmann, R.; Fend, F.; Wallwiener, D. Incidence and Impact of Lymph Node Metastases in Advanced Ovarian Cancer: Implications for Surgical Treatment. J. Cancer 2016, 7 (15), 2241-2246. DOI: 10.7150/jca.15644.

NLM
Bachmann C, Bachmann R, Fend F, Wallwiener D. Incidence and Impact of Lymph Node Metastases in Advanced Ovarian Cancer: Implications for Surgical Treatment. J Cancer 2016; 7(15):2241-2246. doi:10.7150/jca.15644. https://www.jcancer.org/v07p2241.htm

CSE
Bachmann C, Bachmann R, Fend F, Wallwiener D. 2016. Incidence and Impact of Lymph Node Metastases in Advanced Ovarian Cancer: Implications for Surgical Treatment. J Cancer. 7(15):2241-2246.

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