Secondary cytoreductive surgery for isolated lymph node recurrence of epithelial ovarian cancer: A multicenter study

Ferrero, Annamaria; Ditto, Antonino; Giorda, Giorgio; Gadducci, Angiolo; Greggi, Stefano; Daniele, Alberto; Fuso, Luca; Panuccio, Enrico; Scaffa, Cono; Raspagliesi, Francesco; Sismondi, P; Biglia, Nicoletta

doi:10.1016/j.ejso.2013.11.026

Cited by 41 publications

(46 citation statements)

References 30 publications

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“…Retroperitoneal surgery would have an impact on the postoperative course and long-term complications (20). Moreover, some studies suggested the metastasis of lymph nodes was suggested to have had an indolent evolution (30)(31)(32)(33)(34)(35), while related studies are limited.…”

Section: Discussionmentioning

confidence: 99%

Survival Analysis of Lymph Node Resection in Ovarian Cancer: A Population-Based Study

Cheng

Lang

2020

Front. Oncol.

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Objective: This study aimed at comprehensively investigating the survival impact of lymphadenectomy during primary surgery in ovarian cancer. Methods: Based on the surveillance, epidemiology, and end results registry (SEER) database, we included ovarian cancer patients with detailed information between 2010 and 2016. Cox regression was performed to select prognostic factors. We conducted propensity score-weighted survival analysis to balance baseline variables, and series of stratified analyses to control main confounding factors. Results: A total of 8,652 patients were ultimately identified. Among 4,360 patients with advanced disease, lymphadenectomy did not show significant survival benefit in general (median overall survival 44 months in non-lymphadenectomy vs. 49 months in lymphadenectomy group, P = 0.055). In subgroup analysis on patients received optimal debulking, lymphadenectomy did not significantly benefit the survival outcome (median overall survival 51, 47, 60, and 58 months in the non-lymphadenectomy, 1-9 lymph nodes, 10-19 lymph nodes, ≥20 lymph nodes groups, respectively, P = 0.287). Consistent results were observed in further stratification analyses. In optimal debulking subgroup, lymph node metastasis indicated worse survival. However, when limited the number of removed lymph nodes to more than 15, there was a marginal statistical difference in overall survival (P = 0.0498) while no significant difference presented in cause-specific survival (P = 0.129) between non-lymphadenectomy, pathological negative lymph node group and positive lymph node group. And the regions of lymph metastasis were also not significantly associate with survival (P = 0.123). Among 3,266 (75%) patients with apparent early-stage disease received lymphadenectomy, 7.75% of whom were reported isolated lymph nodes metastasis and have a poorer survival (P < 0.05). Conclusions: In primary debulking for patients with advanced ovarian cancer, lymphadenectomy was not associated with more favorable outcomes when compared to no lymphadenectomy. The value of lymphadenectomy lies more in staging for apparent early disease rather than therapeutic benefit.

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Section: Discussionmentioning

confidence: 99%

Survival Analysis of Lymph Node Resection in Ovarian Cancer: A Population-Based Study

Cheng

Lang

2020

Front. Oncol.

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“…There is accumulating evidence for a favorable prognosis in localized recurrence at one or two sites when successful SCS is performed [13,22,31]. Of note, the survival benefit of SCS performed in the setting of isolated lymph node recurrence has been reported to be significant [22,32]. However, even in a localized recurrence at one or two sites, the anatomic site of the relapse could also influence the survival outcome.…”

Section: Non-randomized Observational Studies: Retrospective Designmentioning

confidence: 93%

“…There were several additional prognostic factors studied in other small series: complete clinical response to platinum primary chemotherapy, GOG or ECOG performance status, absence of ascites, size of largest tumor b10 cm, number of recurrence sites 1 or 2 versus ≥3, no salvage chemotherapy prior to SCS, ≥6 cycles of salvage chemotherapy after SCS, serum CA-125 level ≤ 35 U/mL at SCS, and platelet count b350 × 10 9 /L at SCS [13,19,32,38,[41][42][43].…”

Section: Criteria For Selecting Optimal Candidates For Secondary Cytomentioning

confidence: 99%

Surgical management of recurrent ovarian cancer

Suh

Kim

Chang

et al. 2016

Gynecologic Oncology

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“…It is interesting to note that in patients with ovarian cancer, ILAP is reported in up to 3 to 4 % of autopsy and recurrent nodal disease [2,3]. But very few cases document its occurrence at primary presentation and only some of these describe full cilinico pathological details [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…ILAP is considered to occur via lymphatic spread along round ligament or through the blood and is staged with other distant metastasis [7]. However, in most case reports of ILAP in ovarian cancer, management included upfront cytoreductive surgery (CRS), in which complete cytoreduction could be achieved and good survival was seen [3][4][5]8]. This controversy demands further studies to confirm its route of spread and refine the staging and management.…”

Section: Introductionmentioning

confidence: 99%

Presentation and Management of Inguinal Lymphadenopathy in Ovarian Cancer

Giri

Shah

Batra

et al. 2016

Indian J Surg Oncol

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The symptoms in ovarian cancer are often missed leading to dubious diagnosis and staging. Inguinal lymphadenopathy (ILAP) is reported to be rare and occurring via lymphatic or hematogenous route. The paucity of studies on ILAP in ovarian cancer indicates a scope of refining its staging and management. The present study aims to document the presentation and management of ILAP in ovarian cancer, which may also reflect its incidence and mechanism of spread. All patients of ovarian cancer with inguinal lymphadenopathy presenting to our institute from 1 January 2015 to 31 December 2015 were included. All clinical, treatment, and pathological details were analyzed. Seven patients of ovarian cancer presented with ILAP. The mean age and BMI were 53.29 +/− 8.38 years and 26.23 +/− 3.03 kg/m 2 . Presentation varied from advanced disease (adnexal, omental, peritoneal, and nodal) to isolated ILAP even without adnexal mass (n = 4). Mean CA 125 was 229.64 +/− 322 (20-924) and ovarian primary was confirmed on microscopy or immunohistochemistry. Six patients underwent surgery with (n = 4) or without neoadjuvant chemotherapy (n = 2). Complete cytoreduction could be achieved in all patients with acceptable operative and perioperative outcomes. Peritoneal surface spread, along hernia track to the groin, was seen in two patients. Histopathology showed advanced disease, isolated ILAP and no residual disease in 3, 2, and 1 patient, respectively. ILAP has diverse clinical presentation in ovarian cancers and is not that uncommon. ILAP may also occur by peritoneal surface spread and shows good results with cytoreductive surgery and chemotherapy.

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Secondary cytoreductive surgery for isolated lymph node recurrence of epithelial ovarian cancer: A multicenter study

Cited by 41 publications

References 30 publications

Survival Analysis of Lymph Node Resection in Ovarian Cancer: A Population-Based Study

Survival Analysis of Lymph Node Resection in Ovarian Cancer: A Population-Based Study

Surgical management of recurrent ovarian cancer

Presentation and Management of Inguinal Lymphadenopathy in Ovarian Cancer

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