The Validity and Significance of Substage IIIC by Node Involvement in Epithelial Ovarian Cancer: Impact of Nodal Metastasis on Patient Survival

Kanazawa, Kazuki; Suzuki, Takaaki; Tokashiki, Midori

doi:10.1006/gyno.1999.5349

Cited by 59 publications

(41 citation statements)

References 16 publications

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“…Some previous studies suggested that the prognoses of stage IIIC patients who are upstaged based on lymph node positivity are as poor as those of patients with stage IIIC based on intraperitoneal tumor spread. 7,23,24 [25][26][27] However, the better survival of patients upstaged to stage IIIC by positive lymph nodes compared to patients with other stage IIIC could simply reflect the prognostic impact of small versus large tumor size. 28 Therefore, a comparison between stage IIIC solely by lymph node metastasis and stage IIIA/IIIB patients would be more appropriate and provide evidence about possible differences in the biological and clinical behavior of lymph node versus peritoneal metastasis.…”

Section: Discussionmentioning

confidence: 99%

Stage IIIC epithelial ovarian cancer classified solely by lymph node metastasis has a more favorable prognosis than other types of stage IIIC epithelial ovarian cancer

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Stage IIIC epithelial ovarian cancer classified solely by lymph node metastasis has a more favorable prognosis than other types of stage IIIC epithelial ovarian cancer

et al. 2008

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“…12) and no longer as stage IIIC because patients with lymph node involvement without peritoneal involvement have better prognosis [16][17][18][19][20][21]. Less than 10 % of ovarian carcinomas extend beyond the pelvis with exclusively retroperitoneal lymph node involvement [3].…”

Section: Stage IIImentioning

confidence: 99%

Revised FIGO staging system for cancer of the ovary, fallopian tube, and peritoneum: important implications for radiologists

et al. 2015

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“…4 Indeed, survival of patients with node-positive apparent stage I through stage IIIb disease, taken as a whole, is significantly better (P < 0.0001) than that of patients with bulky stage IIIc disease. 5 In 2008, an analysis of SEER data reported that the use of lymphadenectomy during surgery for early-stage ovarian cancer had doubled over the previous 14 years 6 and that lymphadenectomy was a significant independent prognostic indicator for improved survival.…”

Section: Introductionmentioning

confidence: 99%

Defining the surgical management of suspected early‐stage ovarian cancer by estimating patient numbers through alternative management strategies

Warwick

Vardaki

Fattizzi

et al. 2009

BJOG

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Objective To establish the optimal management strategy for women with suspected stage 1 ovarian cancer.Design We created a flowchart to illustrate each of six hypothetical management strategies. These considered two surgical approaches (systematic lymphadenectomy versus no lymph node dissection at all) in combination with three different policies for giving adjuvant chemotherapy.Setting Gynaecological cancer centre, London, UK.Data sources Patient data and published papers. MethodsWe developed a deterministic model that uses information from multiple sources to estimate patient flow through each level of a hypothesised decision tree.Results We estimated that for every 100 cases of suspected earlystage ovarian cancer, there would be 37 cases with 'apparent' stage 1 disease and that of these, two (6%) would be denied potentially life-saving adjuvant treatment if systematic lymphadenectomy was not performed. The number of women given chemotherapy would not, according to our estimates, differ greatly between the two surgical approaches, the 7% increase with systematic lymphadenectomy being because of cases identified as having nodal metastases.Conclusions We present a model of the intraoperative decisionmaking process that determines the extent of the staging procedure to be performed within our department when earlystage ovarian cancer is suspected. Unless adjuvant chemotherapy is prescribed for all, systematic pelvic and para-aortic node dissection is required to optimise survival. However, in our department, this would result in 32% of women with suspected early-stage ovarian cancer undergoing systematic node dissection. This flexible focused model may facilitate multidisciplinary team discussion when this part of the surgical staging procedure is considered within the context of the population presenting to the team, the morbidity of the procedure within the department and the predictive values of frozen section within that department. As the model is not disease-specific, it may be useful for decision making in other medical disciplines.

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The Validity and Significance of Substage IIIC by Node Involvement in Epithelial Ovarian Cancer: Impact of Nodal Metastasis on Patient Survival

Cited by 59 publications

References 16 publications

Stage IIIC epithelial ovarian cancer classified solely by lymph node metastasis has a more favorable prognosis than other types of stage IIIC epithelial ovarian cancer

Stage IIIC epithelial ovarian cancer classified solely by lymph node metastasis has a more favorable prognosis than other types of stage IIIC epithelial ovarian cancer

Revised FIGO staging system for cancer of the ovary, fallopian tube, and peritoneum: important implications for radiologists

Defining the surgical management of suspected early‐stage ovarian cancer by estimating patient numbers through alternative management strategies

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