Patterns of Lymph Node Metastases in Apparent Stage I Low-Grade Epithelial Ovarian Cancer: A Multicenter Study
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie
PubMed
28608122
DOI
10.1245/s10434-017-5919-y
PII: 10.1245/s10434-017-5919-y
Knihovny.cz E-zdroje
- MeSH
- adjuvantní chemoterapie MeSH
- aorta MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfadenektomie * MeSH
- lymfatické metastázy MeSH
- lymfatické uzliny patologie chirurgie MeSH
- míra přežití MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory glandulární a epitelové farmakoterapie sekundární chirurgie MeSH
- nádory vaječníků farmakoterapie patologie chirurgie MeSH
- pánev MeSH
- přežití bez známek nemoci MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- staging nádorů MeSH
- stupeň nádoru MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
OBJECTIVE: The aim of this study was to determine oncological outcomes and incidence of lymph node (LN) metastases in women who underwent systematic pelvic and paraaortic lymphadenectomy for surgical staging of apparent stage I low-grade epithelial ovarian cancer (LGEOC). MATERIALS AND METHODS: A retrospective study was performed at nine institutions across Europe and the US, and patients who underwent surgical staging for presumed stage I LGEOC between 2000 and 2016 were included. To ensure surgical quality, a minimum number of ≥10 pelvic and ≥10 paraaortic LNs was required. Patients with preoperative radiologic or clinical evidence of extraovarian or LN disease, and those with nonepithelial histology, were excluded. RESULTS: The overall incidence of LN metastases was 4.3% in the 163 evaluated patients, and the incidence of LN involvement in serous, endometrioid, and mucinous subtypes was 10.7, 1.5, and 0%, respectively. However, Upstaging due to LN involvement alone occurred in only 2.4% of the patients. Eighty-nine (54.6%) patients received adjuvant chemotherapy due to International Federation of Gynecology and Obstetrics stage IC or higher disease. The 5-year progression-free survival (PFS) and overall survival (OS) were 93.2% (95% confidence interval [CI] 89.4-97.1%) and 94.5% (95% CI 90.9-98.0%), respectively. There was no significant difference in PFS or OS between LN-negative and LN-positive patients. However, fewer patients received adjuvant chemotherapy in the LN-negative group. Multivariate analysis did not identify any independent prognostic factor of survival. CONCLUSION: The risk of LN involvement in nonserous apparent stage I LGEOC appears low, with a rate of <1% in this retrospective analysis, raising questions about the value of lymphadenectomy in those patients. Larger-scale prospective studies are warranted to evaluate the oncologic safety of omitting systematic LN staging in apparent stage I nonserous LGEOC.
Department of Applied Mathematics and Statistics CEU San Pablo University Madrid Spain
Department of Gynaecology Imperial College London London UK
Department of Gynecology European Institute of Oncology Milan Italy
Department of Gynecology Instituto Valenciano de Oncología Valencia Spain
Department of Women's and Children's Health Catholic University of the Sacred Heart Rome Italy
Division of Gynecologic Surgery Mayo Clinic Rochester MN USA
Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
Gynecologic Oncology Unit La Paz University Hospital IdiPAZ Madrid Spain
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