Patterns of pelvic and paraaortic lymph node involvement in ovarian cancer

Burghardt, E; Girardi, Frank; Lahousen, M.; Tamussino, Karl; Stettner, Haro

doi:10.1016/0090-8258(91)90099-q

Cited by 270 publications

(97 citation statements)

References 8 publications

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“…1 Although it has been reported that the prognosis of patients with USO was not as satisfactory as that of patients with both hysterectomy and BSO, 18 the present study demonstrated that the preservative operation was effective, because adjuvant chemotherapy including cisplatin improved the overall prognosis of stage I patients. Although lymphadenectomy is not yet regarded as standard treatment in stage I ovarian cancer, 14 the frequency of lymph node metastasis has been reported to be 23% 20 and 24%, 21 higher than the rate of 5.5% in this study.…”

Section: Discussioncontrasting

confidence: 81%

Multivariate analysis of prognostic factors in stage I ovarian cancer

Kudoh

Kase

Tanaka

et al. 1999

International Journal of Clinical Oncology

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Background. As the prognosis of ovarian cancer has improved with recent therapy, some prognostic factors have lost their clinical significance. The purpose of this study was to evaluate prognostic factors in stage I ovarian cancer in patients with improved prognosis because of cisplatin combination chemotherapy. Methods. Multivariate analysis was performed with 14 clinicopathologic prognostic factors obtained from 170 patients with stage I ovarian cancer (borderline tumors were excluded), who had been surgically treated between 1983 and 1995. Results. The 5-year survival rate was 94.5% for all stage I patients, 98.0% in stage IA, 100% in stage IB, and 92.6% in stage IC. Significant prognostic factors determined by the Kaplan-Meier method were spontaneous rupture of the capsule and capsular invasion (P Ͻ 0.05, and P Ͻ 0.01). Multivariate analysis, however, showed that spontaneous rupture of the capsule was the only significant prognostic factor (P ϭ 0.02627). Both analyses showed that histologic type, histologic grading, intrapelvic cytology, operative procedure, and chemotherapy had little influence on prognosis. Conclusion. Multivariate analysis showed that spontaneous rupture of the capsule was the only significant prognostic factor in patients with stage I ovarian cancer who received cisplatin chemotherapy.

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Section: Discussioncontrasting

confidence: 81%

Multivariate analysis of prognostic factors in stage I ovarian cancer

Kudoh

Kase

Tanaka

et al. 1999

International Journal of Clinical Oncology

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“…Epithelial ovarian carcinomas have higher prevalence rates for both aortic and pelvic lymph node metastases 10 -12 compared with other gynecologic malignancies. 13,14 We have demonstrated that over 20% of patients with intraperitoneal tumors limited to the pelvis are classified as Stage III based on the detection of positive lymph nodes by systematic aortic and pelvic lymphadenectomy. 15 When only lymph node biopsies are performed, the prognoses of Stage III patients upstaged based on lymph node positivity are known to be as poor as those of patients with Stage III based on intraperitoneal tumor spread.…”

mentioning

confidence: 99%

Patients with ovarian carcinoma upstaged to Stage III after systematic lymphadenctomy have similar survival to Stage I/II patients and superior survival to other Stage III patients

Onda

Yoshikawa

Yasugi

et al. 1998

Cancer

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“…It has been reported that lymph node metastases are frequently demonstrated (24%) even in patients whose intraabdominal findings indicate stage I disease. 31 Kuramoto et al 18 reported a patient in whom a micrometastatic lesion was detected in the paraaortic lymph node, although the tumor was judged to be stage Ia from the pelvic cavity findings. Adachi and colleagues 32 reported a patient who underwent simple total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy and was diagnosed with stage Ia ovarian carcinoma, who had a recurrence in the paraaortic lymph node within 6 months of the surgery.…”

Section: Discussionmentioning

confidence: 97%

Conservative surgery for malignant ovarian tumor in women of childbearing age

Jobo

Yonaha

Iwaya

et al. 2000

International Journal of Clinical Oncology

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Background. The traditional operative procedures for the treatment of ovarian cancer have been simple total hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. However, young patients who want to preserve fertility are occasionally encountered. This study was designed to assess the results of conservative surgical management for young women with stage I epithelial ovarian carcinoma or malignant germ cell tumor and to explore the indications for such surgical treatment. Methods. Fifty-eight patients aged under 35 years were treated for malignant ovarian tumors (germ cell tumor, n = 20; epithelial tumors, n = 38) between 1971 and 1996. We studied all 20 patients with germ cell tumors and 22 pa-tients with stage I epithelial tumors; we excluded the 12 patients with stage II and more advanced disease and the 4 patients with stage I clear cell carcinoma, because these patients had poor prognoses. Eleven of the 22 patients with stage I epithelial tumors and 8 of the 20 patients with germ cell tumors received conservative surgery (conservative surgery group); the remaining 23 patients underwent radical surgery, including hysterectomy and bilateral salpingo-oophorectomy (radical surgery group). The overall survival rates of the two groups were compared, and ovarian function and pregnancy outcome were evaluated in the conservative surgery group. Results. Of the patients with malignant epithelial tumor who were treated with conservative surgery, 3 patients with stage Ic mucinous adenocarcinoma died 1 year and 8 months, 7 years and 6 months, and 8 years, respectively, after the initial surgery. The 10-year survival rate was 65% for the conservative surgery group and 91% for the radical surgery group. All patients with stage Ia epithelial tumors in both groups survived, and there were no differences in survival curves between the two groups among the patients with stage Ic epithelial tumors. All patients with germ cell tumors in the conservative surgery group survived. Their survival rate, however, was not significantly better than that in the radical surgery group. All patients with germ cell tumors who received platinum-based chemotherapy survived and had a significantly better survival rate than those who received non-platinum-based regimens (P < 0.05). All the patients in the conservative surgery group received postoperative chemotherapy; 10 of these patients had transient ovulation failure after the completion of chemotherapy, although a normal menstrual cycle was restored within 1 year. Of the 10 patients who wished to have babies, 6 became pregnant, and they have had a total of 11 children. Conclusion. Conservative surgery is feasible in patients with stage Ia epithelial carcinoma and germ cell tumor. Postoperative chemotherapy suppressed ovarian function in these patients, but only for a brief period.

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Patterns of pelvic and paraaortic lymph node involvement in ovarian cancer

Cited by 270 publications

References 8 publications

Multivariate analysis of prognostic factors in stage I ovarian cancer

Multivariate analysis of prognostic factors in stage I ovarian cancer

Patients with ovarian carcinoma upstaged to Stage III after systematic lymphadenctomy have similar survival to Stage I/II patients and superior survival to other Stage III patients

Conservative surgery for malignant ovarian tumor in women of childbearing age

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