Lymphadenectomy in surgical stage I epithelial ovarian cancer

Svolgaard, Olivia; Lidegaard, Øjvind; Nielsen, Marie Louise; Nedergaard, Lotte; Mosgaard, Berit Jul; Lidang, Marianne; Mogensen, Ole; Kock, Kirsten; Blaakær, Jan; Stæhr, Estrid; Andersen, E.; Grove, Anni; Høgdall, Claus

doi:10.1111/aogs.12322

Cited by 14 publications

(17 citation statements)

References 17 publications

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“…We pooled the relative risks from individual studies using a fixed-effect model and found that SL improved the 5-year OS in all 16 sets of data (RR = 1.08; P = 0.001, 95%CI: 1.03-1.13) (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). Because of differences in the experimental design, we combined observational studies and RCTs, respectively, as the latter are more convincing than the former.…”

Section: Discussionmentioning

confidence: 99%

“…Saygili et al (15): had no conflict of interest statement; without long enough follow-up time; high rate of defaulters. The remaining 11 observational studies whose scores ranged from 7 to 9 with a median score of 8 (16)(17)(18)(19)(20)(23)(24)(25)(27)(28)(29) and three RCTs (21-22,26) with scores from 4 to 5 were finally included in our analyses. Figure 1 shows an overview of the process of selection.…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

“…These articles, including 1783 cases and 1705 controls, were published between 1994 and 2013 and consisted of 11 observational studies (16)(17)(18)(19)(20)(23)(24)(25)(27)(28)(29) and three RCTs (21)(22)26). Among the included studies, SL was defined as follows: (i) either pelvic or paraaortic lymphadenectomy or both (16)(17)(19)(20)21,(23)(24)(25)(26)(27)(28)(29); (ii) >20 resected pelvic and para-aortic lymph nodes (18,22). On the other hand, USL was defined as follows: not performed or no lymphadenectomy other than suspicious lymph nodes and the removal number was <20.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Systematic lymphadenectomy in the treatment of epithelial ovarian cancer: a meta-analysis of multiple epidemiology studies

Gao

Yang

Zhang

2014

Japanese Journal of Clinical Oncology

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Objective: To evaluate the role of systematic lymphadenectomy in epithelial ovarian cancer by comparing 5-year overall survival rates between systematic and unsystematic lymphadenectomies. Methods: A literature search of the Pubmed, Embase and Cochrane Library databases was performed up to 2014. Two authors independently determined the eligibility of the articles and extracted the available data. The role of systematic lymphadenectomy in epithelial ovarian cancer was analyzed by combining all qualified individual studies using a fixed-effect model. Then, subgroup analysis was performed by dividing articles according to type, cancer stage and residual tumor. Finally, heterogeneity and publication bias in all enrolled studies were assessed using Higgins I 2 statistics and funnel plots, respectively.Results: Fourteen relevant studies including 3488 subjects were included in the analysis. The value of pooled relative ratios of all qualified studies revealed that the 5-year overall survival rate in the lymphadenectomy group was higher than that in the unsystematic lymphadenectomy group (relative ratio = 1.08; P = 0.001), which was duplicated in the subgroup analysis of observational studies (relative ratio = 1.07; P = 0.002) and advanced stage (relative ratio = 1.21; P = 0.012) epithelial ovarian cancer. No significant differences were observed in randomized controlled trials (relative ratio = 1.01; P = 0.858), early stage epithelial ovarian cancer (relative ratio = 1.06; P = 0.064) or patients with residual tumor ≤2 cm (relative ratio = 1.05; P = 0.125). The heterogeneity and publication bias in the enrolled studies were within acceptable thresholds. Conclusions: Lymphadenectomy can improve the 5-year overall survival rate in advanced stage epithelial ovarian cancer but not in early stage epithelial ovarian cancer or in patients with residual tumor ≤2 cm.

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Section: Discussionmentioning

confidence: 99%

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Systematic lymphadenectomy in the treatment of epithelial ovarian cancer: a meta-analysis of multiple epidemiology studies

Gao

Yang

Zhang

2014

Japanese Journal of Clinical Oncology

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“…Our slightly lower one-year survival may partly be explained by the fact that Denmark, in contrary to other countries, did not recommend lymph node resection on stage I patients until 2005. Lymph node removal was nationally implemented in 2012, which is why only 25% of patients in 2005 and 55% of patients in 2011 had this procedure performed [20]. Between 6% and 20% of patients are otherwise expected to have lymph node metastases at time of diagnosis, and in accordance with the FIGO classification, these patients should be reclassified as stage III [12].…”

Section: Comparison and Discussionmentioning

confidence: 99%

Survival of ovarian cancer patients in Denmark: Results from the Danish gynaecological cancer group (DGCG) database, 1995–2012

et al. 2016

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Background: Ovarian cancer has a high mortality rate, especially in Denmark where mortality rates have been reported higher than in adjacent countries with similar demographics. This study therefore examined recent survival and mortality among Danish ovarian cancer patients over an 18-year study period.Methods: This nationwide registry-based observational study used data from the Danish Gynecology Cancer Database, Danish Pathology Registry, and Danish National Patient Registry. All patients with ovarian cancer diagnosed between 1995 and 2012 were included in the study. The data sources were linked via the patients' personal identification number and the analyses included data on cancer stage, age, survival, surgery status and comorbidity. The computed outcome measures were age-adjusted mortality rates and age-adjusted overall and relative survival rates for one and five years.

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“…The aim was to evaluate the Danish nationwide progress in implementing lymphadenectomy for women presenting with tumor(s) macroscopically confined to the ovary, and the effect of lymphadenectomy on the overall survival. The study concluded that the national number of lymphadenectomies was too low, although increasing, and that the effect of lymphadenectomies on overall survival was not significant 9. The results of the study formed the basis for a very intense debate about systematic lymphadenectomy and revision of guidelines.…”

Section: Examples Of Researchmentioning

confidence: 97%

Danish Gynecological Cancer Database

Sørensen¹,

Bjørn²,

Jochumsen³

et al. 2016

CLEP

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Aim of databaseThe Danish Gynecological Cancer Database (DGCD) is a nationwide clinical cancer database and its aim is to monitor the treatment quality of Danish gynecological cancer patients, and to generate data for scientific purposes. DGCD also records detailed data on the diagnostic measures for gynecological cancer.Study populationDGCD was initiated January 1, 2005, and includes all patients treated at Danish hospitals for cancer of the ovaries, peritoneum, fallopian tubes, cervix, vulva, vagina, and uterus, including rare histological types.Main variablesDGCD data are organized within separate data forms as follows: clinical data, surgery, pathology, pre- and postoperative care, complications, follow-up visits, and final quality check. DGCD is linked with additional data from the Danish “Pathology Registry”, the “National Patient Registry”, and the “Cause of Death Registry” using the unique Danish personal identification number (CPR number).Descriptive dataData from DGCD and registers are available online in the Statistical Analysis Software portal. The DGCD forms cover almost all possible clinical variables used to describe gynecological cancer courses. The only limitation is the registration of oncological treatment data, which is incomplete for a large number of patients.ConclusionThe very complete collection of available data from more registries form one of the unique strengths of DGCD compared to many other clinical databases, and provides unique possibilities for validation and completeness of data. The success of the DGCD is illustrated through annual reports, high coverage, and several peer-reviewed DGCD-based publications.

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Lymphadenectomy in surgical stage I epithelial ovarian cancer

Abstract: Although increasing, the number of women with surgical stage I disease in Denmark who receive lymphadenectomy remains low, but this did not seem to make a difference to survival.

Cited by 14 publications

References 17 publications

Systematic lymphadenectomy in the treatment of epithelial ovarian cancer: a meta-analysis of multiple epidemiology studies

Systematic lymphadenectomy in the treatment of epithelial ovarian cancer: a meta-analysis of multiple epidemiology studies

Survival of ovarian cancer patients in Denmark: Results from the Danish gynaecological cancer group (DGCG) database, 1995–2012

Danish Gynecological Cancer Database

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