Prognostic value of lymph node ratio in patients with advanced epithelial ovarian cancer

Ataseven, Beyhan; Grimm, Christoph; Harter, Philipp; Prader, Sonia; Traut, Alexander; Heitz, Florian; Bois, Andreas du

doi:10.1016/j.ygyno.2014.10.003

Cited by 51 publications

(55 citation statements)

References 22 publications

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“…This corresponds with the prospective randomized phase III Lymphadenectomy in Ovarian Neoplasms trial, which addressed the value of systematic lymphadenectomy in advanced ovarian cancer, of which study protocol requires a minimum of 20 pelvic and 10 para-aortic LNs (ClinicalTrials identifier: NCT00712218). 39 In our analysis, no realiable conclusions can be drawn regarding an ideal number of LNs; however, it is interesting to note that the positive LNs were from studies where the median number of removed LNs was more than 30 pelvic and 10 para-aortic, which also corresponds with our experience that the number of LNs is a surrogate marker of the quality of lymphadenectomy and hence with lower number of false-negative results.…”

Section: Discussionsupporting

confidence: 59%

Incidence of Lymph Node Metastases in Apparent Early-Stage Low-Grade Epithelial Ovarian Cancer: A Comprehensive Review

Lago¹,

Minig²,

Fotopoulou³

2016

Int J Gynecol Cancer

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Section: Discussionsupporting

confidence: 59%

Incidence of Lymph Node Metastases in Apparent Early-Stage Low-Grade Epithelial Ovarian Cancer: A Comprehensive Review

Lago¹,

Minig²,

Fotopoulou³

2016

Int J Gynecol Cancer

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“…This parameter showed superiority to the lymph node status-based assessment system of N stage in several cancers, such as breast [6, 12], gastric [8], and colon cancer [13, 14]. LNR was also studied in ovarian cancer and found to be superior to both PLN and RLN number in predicting survival [15, 16]. …”

Section: Introductionmentioning

confidence: 99%

A novel nomogram based on LODDS to predict the prognosis of epithelial ovarian cancer

Cheng

Tang³

et al. 2016

Oncotarget

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BACKGROUNDTo develop and validate a nomogram based on log of odds between the number of positive lymph node and the number of negative lymph node (LODDS) in predicting the overall survival (OS) and cancer specific survival (CSS) for epithelial ovarian cancer (EOC) patients.MATERIALS AND METHODSA total of 10,692 post-operative EOC patients diagnosed between 2004 and 2013 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training (n = 7,021) and validation (n = 3,671) cohorts. Multiple clinical pathological parameters were assessed and compared with outcomes. Parameters significantly correlating with outcomes were used to build a nomogram. Bootstrap validation was subsequently used to assess the predictive value of the model.RESULTSIn the training set, age at diagnosis, race, marital status, tumor location, stage, grade and LODDS were correlated significantly with outcome in both the univariate and multivariate analyses and were used to develop a nomogram. The nomogram demonstrated good accuracy in predicting OS and CSS, with a bootstrap-corrected concordance index of 0.757 (95% CI, 0.746-0.768) for OS and 0.770 (95% CI, 0.759-0.782) for CSS. Notably, in this population our model performed favorably compared to the currently utilized Federation of Gynecology and Obstetrics (FIGO) model, with concordance indices of 0.699 (95% CI, 0.688-0.710, P < 0.05) and 0.719 (95% CI, 0.709- 0.730, P < 0.05) for OS and CSS, respectively. Using our nomogram in the validation cohort, the C-indices were 0.757 (95% CI, 0.741-0.773, P < 0.05, compared to FIGO) for OS and 0.762 (95% CI, 0.746-0.779, P < 0.05, compared to FIGO) for CSS.CONCLUSIONSLODDS works as an independent prognostic factor for predicting survival in patients with EOC regardless of the tumor stage. By incorporating LODDS, our nomogram may be superior to the currently utilized FIGO staging system in predicting OS and CSS among post-operative EOC patients.

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“…In FIGO stage I, a large number of resected lymph nodes did not represent a better outcome. The patients with [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] RLNs have the best prognosis. When RLNs numbered more than 30, the survival rate decreased.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, increasing attention has been paid to lymph node status, which can be evaluated by the number of resected lymph nodes (RLNs), 15 lymph node ratio (LNR), [16][17][18] and the log odds of positive lymph nodes (LODDS). [19][20][21][22][23][24] Compared to a single parameter, LNR exhibits its advantage in breast, [25][26][27][28] pancreatic, 19 colon, [29][30][31][32] and ovarian 16,18 cancers. Another parameter, LODDS, showed superiority in predicting outcomes in breast, 20 pancreatic, 19,21 colorectal, 22,23 and ovarian 24 cancers.…”

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confidence: 99%

Survival effect of different lymph node staging methods on ovarian cancer: An analysis of 10 878 patients

Wang

Chen

et al. 2018

Cancer Medicine

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BackgroundTo compare the survival impact of several lymph node staging methods and therapeutic role of lymphadenectomy in patients with epithelial ovarian cancer who had undergone lymphadenectomy.MethodsData were retrospectively collected from the Surveillance, Epidemiology, and End Results program between 1988 and 2013.ResultsAn increasing number of resected lymph nodes (RLNs) was associated with a significant improvement in survival of FIGO stage II and III disease. However, for FIGO stage IV patients, better survival was not significantly associated with a more extensive lymphadenectomy. A higher lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) were associated with poorer survival regardless of stage. Nevertheless, four‐category classification of LODDS was more suitable for stage IV patients when three‐category classification was compatible with stage I‐III disease. Multivariate analysis demonstrated that LODDS and LNR were significant independent prognostic factors, but not RLN classification.ConclusionSixteen to thirty RLNs are recommended for stage I disease. For stages II and III patients, the more lymph node excision, the better the prognosis. However, lymphadenectomy was nonessential for stage IV patients. Considering staging methods, for stages II and III patients, three‐category classification of LODDS was recommended to evaluate the prognosis. For stage I and IV, three‐category classification of positive LNR was idoneous.

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Prognostic value of lymph node ratio in patients with advanced epithelial ovarian cancer

Cited by 51 publications

References 22 publications

Incidence of Lymph Node Metastases in Apparent Early-Stage Low-Grade Epithelial Ovarian Cancer: A Comprehensive Review

Incidence of Lymph Node Metastases in Apparent Early-Stage Low-Grade Epithelial Ovarian Cancer: A Comprehensive Review

A novel nomogram based on LODDS to predict the prognosis of epithelial ovarian cancer

Survival effect of different lymph node staging methods on ovarian cancer: An analysis of 10 878 patients

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