Les métastases ganglionnaires du cancer épithélial de l'ovaire sont-elles chimio-sensibles ? Étude comparative de la lymphadénectomie première ou après chimiothérapie

Joulie, F.; Morice, Philippe; Rey, Annie; Thoury, A.; Camatte, S.; Pautier, Patricia; Lhommé, C.; Haie-Méder, Christine; Duvillard, P.; Castaigne, Damienne

doi:10.1016/j.gyobfe.2004.04.009

Cited by 9 publications

(2 citation statements)

References 32 publications

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“…In our study, metastatic implants were found in retrieved lymph nodes despite neoadjuvant chemotherapy including 10% and 13% in pelvic and paraaortic metastasis nodes, respectively. Two studies showed that that the rate of nodal involvement was similar in patients treated before or after chemotherapy, suggesting that nodal metastases are not chemosensitive [ 20 , 45 ]. From a physiological point of view, these results are in favor of systematic LND.…”

Section: Discussionmentioning

confidence: 99%

Impact of Lymphadenectomy on Survival of Patients with Serous Advanced Ovarian Cancer After Neoadjuvant Chemotherapy: A French National Multicenter Study (FRANCOGYN)

Bund

Lecointre

Velten

et al. 2020

JCM

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Background: The population of interest to this study comprised individuals with advanced-stage ovarian carcinoma who were exposed to neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). Those who had not received systematic lymphadenectomy (SL; Group 1) were compared to those who had received SL (Group 2). Outcome measures included progression-free survival (PFS), overall survival (OS), and surgical complications. Methods: This was a retrospective, multicenter cohort study in nine referral centers of France between January 2000 and June 2017. OS analysis using the multivariate Cox regression model was performed. PFS and surgery-related morbidity were analyzed. Results: Of the 255 patients included, 100 were in Group 1 and 155 in Group 2. Patient majority was, on average, younger and less comorbid, with predominant R0 surgery in Group 2. Dindo–Clavien score was similar between the two groups (p = 0.15). Median OS was 26.8 months in Group 2 and 27.6 months in Group 1. SL was not statistically significant on OS (p = 0.7). Median PFS was 18.3 months in Group 2 and 16.6 months in Group 1. SL had positive impact on PFS (p = 0.005). Conclusions: patients who had received SL (Group 2) had significantly higher PFS regardless of node-positivity status when compared to those who had not received SL (Group 1).

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Section: Discussionmentioning

confidence: 99%

Impact of Lymphadenectomy on Survival of Patients with Serous Advanced Ovarian Cancer After Neoadjuvant Chemotherapy: A French National Multicenter Study (FRANCOGYN)

Bund

Lecointre

Velten

et al. 2020

JCM

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“…The question if this postulate can be transposed to the NACT setting is not answered yet; however, it is frequently performed during clinical practice. The lymph node sanctuary of chemoresistance has been described for a long time, with the finding that lymph node metastasis persisted in 36% to 54% of lymph nodes after chemotherapy, suggesting that metastatic lymph nodes are not chemosensitive lesions [ 10 ]. Interesting data from Di Re et al reported, in 2000, a 17% of positive lymph nodes after NACT [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of Lymphadenectomy after Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer: A Review of Available Data

Seidler

Koual

Achen

et al. 2021

JCM

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Recent robust data allow for omitting lymph node dissection for patients with advanced epithelial ovarian cancer (EOC) and without any suspicion of lymph node metastases, without compromising recurrence-free survival (RFS), nor overall survival (OS), in the setting of primary surgical treatment. Evidence supporting the same postulate for patients undergoing complete cytoreductive surgery after neoadjuvant chemotherapy (NACT) is lacking. Throughout a systematic literature review, the aim of our study was to evaluate the impact of lymph node dissection in patients undergoing surgery for advanced-stage EOC after NACT. A total of 1094 patients, included in six retrospective series, underwent either systematic, selective or no lymph node dissection. Only one study reveals a positive effect of lymphadenectomy on OS, and two on RFS. The four remaining series fail to demonstrate any beneficial effect on survival, neither for RFS nor OS. All of them highlight the higher peri- and post-operative complication rate associated with systematic lymph node dissection. Despite heterogeneity in the design of the studies included, there seems to be a trend showing no improvement on OS for systematic lymph node dissection in node negative patients. A well-conducted prospective trial is mandatory to evaluate this matter.

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Place du curage ganglionnaire lombo-aortique et pelvien dans les cancers épithéliaux de l’ovaire

Bobin¹,

Schneider²

Abord Clinique

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Les métastases ganglionnaires du cancer épithélial de l'ovaire sont-elles chimio-sensibles ? Étude comparative de la lymphadénectomie première ou après chimiothérapie

Cited by 9 publications

References 32 publications

Impact of Lymphadenectomy on Survival of Patients with Serous Advanced Ovarian Cancer After Neoadjuvant Chemotherapy: A French National Multicenter Study (FRANCOGYN)

Impact of Lymphadenectomy on Survival of Patients with Serous Advanced Ovarian Cancer After Neoadjuvant Chemotherapy: A French National Multicenter Study (FRANCOGYN)

Clinical Impact of Lymphadenectomy after Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer: A Review of Available Data

Place du curage ganglionnaire lombo-aortique et pelvien dans les cancers épithéliaux de l’ovaire

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