Clinical features and outcomes of neck lymphatic metastasis in ovarian epithelial carcinoma

Chen, Chien-Wen; Torng, Pao-Ling; Chen, Chi‐Ling; Chen, Chi-An

doi:10.1186/1477-7819-11-255

Cited by 12 publications

(10 citation statements)

References 18 publications

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“…However, cancer spreading through the lymphatic system could result in further extension to the cervical lymph nodes. In these cases, lymph node metastases in the neck are considered to be distant metastases and are classified as International Federation of Gynecology and Obstetrics stage IV . Such cases have been rarely reported and usually have poor outcomes.…”

Section: Specific Primary Tumor Sitesmentioning

confidence: 99%

“…Neck metastases can be discovered at the same time as initial exploration of the ovarian cancer or at the time of cancer recurrence. The interval between the diagnosis of the ovarian neoplasm and the subsequent tumor involving the neck is usually long, occurring at a mean period of 43.3 to 124 months (range, 5–240 months) …”

Section: Specific Primary Tumor Sitesmentioning

confidence: 99%

“…Chen et al reported a case series of 20 patients with ovarian cancer with neck lymph node metastases. They concluded that a subgroup of patients with neck metastases who had presented with limited pelvic cancer had much better overall survival than those patients who had cancer spreading beyond the pelvic cavity or were diagnosed with neck lymph node metastases when the primary ovarian cancer had recurred.…”

Section: Specific Primary Tumor Sitesmentioning

confidence: 99%

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Cervical lymph node metastases from remote primary tumor sites

et al. 2015

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Although most malignant lymphadenopathy in the neck represent lymphomas or metastases from head and neck primary tumors, occasionally, metastatic disease from remote, usually infraclavicular, sites presents as cervical lymphadenopathy with or without an obvious primary tumor. In general, these tumors metastasize to supraclavicular lymph nodes, but occasionally may present at an isolated higher neck level. A search for the primary tumor includes information gained by histology, immunohistochemistry, and evaluation of molecular markers that may be unique to the primary tumor site. In addition, 18F-fluoro-2-deoxyglocose positron emission tomography combined with CT (FDG-PET/CT) has greatly improved the ability to detect the location of an unknown primary tumor, particularly when in a remote location. Although cervical metastatic disease from a remote primary site is often incurable, there are situations in which meaningful survival can be achieved with appropriate local treatment. Management is quite complex and requires a truly multidisciplinary approach.

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Section: Specific Primary Tumor Sitesmentioning

confidence: 99%

Section: Specific Primary Tumor Sitesmentioning

confidence: 99%

Section: Specific Primary Tumor Sitesmentioning

confidence: 99%

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Cervical lymph node metastases from remote primary tumor sites

et al. 2015

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“…Eleven of the 20 patients in their report had neck lymph node metastasis at the time of initial surgery for epithelial ovarian cancer (9/11 were serous histology). Median survival was 42 months (range 6–115 months) 8. Extent of surgical debulking was not reported.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of supraclavicular lymphadenopathy in patients with high-grade serous ovarian cancer

Cybulska

Hayes

Spirtos

et al. 2019

Int J Gynecol Cancer

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ObjectivesTo assess outcomes and patterns of recurrence in patients with high-grade serous ovarian/tubal/primary peritoneal cancers with radiographic supraclavicular lymphadenopathy at diagnosis.MethodsWe evaluated all patients with newly diagnosed high-grade serous ovarian cancers treated at our center between January 1, 2008 and May 1, 2013 who had supraclavicular lymphadenopathy (defined as ≥1 cm in short axis) on radiographic imaging (either computed tomography or positron emission tomography) at the time of diagnosis.ResultsOf 586 patients with high-grade serous ovarian cancer receiving primary treatment during the study period, we identified 13 (2.2%) with supraclavicular lymphadenopathy diagnosed on pre-treatment imaging. The median age at diagnosis was 52.0 years (range 38.2–72.3). Five (31%) had clinically palpable nodes on physical examination. Four (31%) had a known BRCA mutation. All 13 patients underwent neoadjuvant chemotherapy, followed by interval debulking surgery. Each patient received a median of four cycles of neoadjuvant intravenous chemotherapy (range 3–7). At interval debulking surgery, complete gross resection was achieved in nine (70%) patients, and optimal resection (0.1–1 cm residual disease) in four (30%). Eleven patients (85%) recurred; however, only one (8%) recurred in the supraclavicular lymph nodes. Median follow-up time was 44.3 months (range 22.4–95.0). Median progression-free survival for the cohort was 11.7 months (95% CI 9.2 to 14.1). Median overall survival was 44.3 months (95% CI 41.5 to 47.1). In patients obtaining complete gross resection at interval debulking surgery, median progression-free survival and overall survival were 13.9 months (95% CI 8.9 to 18.9) and 78.1 months (95% CI 11.1 to 145.1), respectively.ConclusionsIn our study, approximately 2% of patients with high-grade serous ovarian cancer presented with radiographic evidence of supraclavicular lymphadenopathy. Supraclavicular lymphadenopathy at diagnosis did not portend an unfavorable outcome when complete gross resection was achieved at interval debulking surgery.

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“…Chen CW et al publicaron una serie de casos con 20 pacientes con CO y que presentaban metástasis ganglionares a nivel cervical. Entre las conclusiones de dicho estudio, se observó que aquellas pacientes con neoplasia limitada a la pelvis, mostraban una supervivencia global mucho mayor que aquellas con diseminación a distancia o metástasis ganglionares cervicales recurrentes de un CO previo (14). Las metástasis de cuello pueden aparecer también como primer signo de recurrencia en el CO, aunque solo en el 4-6% de los casos suponen la única manifestación de la recidiva.…”

Section: Discussionunclassified

Carcinoma de ovario en paciente con mutación del gen BRCA1. Diagnóstico tras biopsia de adenopatía cervical, en el contexto de un síndrome paraneoplásico cutáneo.

Novo

Garrido

Sánchez

et al. 2018

Rev. chil. obstet. ginecol.

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Carcinoma de ovario en paciente con mutación del gen BRCA1. Diagnóstico tras biopsia de adenopatía cervical, en el contexto de un síndrome paraneoplásico cutáneo. RESUMENEl cáncer epitelial de ovario representa uno de los tumores ginecológicos más letales ya que más del 75% de las pacientes son diagnosticadas en estadío avanzado. Aún no se ha demostrado que la realización de pruebas y exámenes pélvicos rutinarios haya reducido la mortalidad, no existiendo actualmente, un cribado eficaz para su diagnóstico precoz. Aunque la sintomatología metastásica extraperitoneal más común es el derrame pleural, las linfadenopatías neoplásicas a nivel supraclavicular aparecen hasta en el 4% de casos, generalmente asociándose a un mal pronóstico. La identificación de una adenopatía supraclavicular se relaciona hasta en un 58-83% de los casos, con el hallazgo de una tumoración maligna. Por otro lado, la dermatomiositis del adulto puede tener un origen paraneoplásico en un 15-25% de las ocasiones, siendo el cáncer de mama y de ovario la etiología más frecuente en la población femenina. Las pacientes portadoras de mutaciones en los genes BRCA 1 y 2 tienen un aumento del riesgo de padecer neoplasias de mama y ovario. En aquellas afectas de un cáncer de ovario y portadoras de una mutación en los genes BRCA, no se debería plantear una cirugía profiláctica de rutina sobre la mama, al menos en los primeros 5 años tras el diagnóstico de la neoplasia ovárica. Presentamos el caso de una paciente portadora de una mutación germinal del gen BRCA 1, que debuta con un cáncer de ovario, tras el estudio de una adenopatía neoplásica de cuello, biopsiada en el contexto de un síndrome paraneoplásico cutáneo.PALABRAS CLAVE: BRCA, metástasis supracervical, cáncer de mama, cáncer de ovario, mastectomía profiláctica, cáncer hereditario, dermatomiositis. ABSTRACTEpithelial ovarian cancer represents one of the most lethal gynecological tumors, since more than 75% of affected women are diagnosed at an advanced stage. However, studies have not demonstrated yet that performing routine pelvic exams and tests had reduced mortality in ovarian cancer, and currently there is no effective screening for early diagnosis. The most common extraperitoneal metastatic symptomatology of ovarian cancer is pleural effusion, but there are other, like neoplastic lymphadenopathies at supraclavicular level, described in up to 4% of cases and generally related to a poor prognosis. The identification of a supraclavicular adenopathy is associated with the finding of a malignant tumor in 58-83% of the cases. On the other hand, adult

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Clinical features and outcomes of neck lymphatic metastasis in ovarian epithelial carcinoma

Cited by 12 publications

References 18 publications

Cervical lymph node metastases from remote primary tumor sites

Cervical lymph node metastases from remote primary tumor sites

Prognostic significance of supraclavicular lymphadenopathy in patients with high-grade serous ovarian cancer

Carcinoma de ovario en paciente con mutación del gen BRCA1. Diagnóstico tras biopsia de adenopatía cervical, en el contexto de un síndrome paraneoplásico cutáneo.

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