The role of lymphadenectomy in node-positive epithelial ovarian cancer

Augusto Pereira, Tirso Pérez-Medina, Javier F. Magrina, Paul Magtibay, Isabel Millan, Enrique Iglesias

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To evaluate the therapeutic role of pelvic and aortic lymphadenectomy in patients with epithelial ovarian cancer (EOC) and positive nodes (stages IIIC and IV). Methods: Retrospective chart review. Data from all consecutive patients with EOC and positive retroperitoneal lymph nodes (stage IIIC and IV) in Mayo Clinic from 1996 to 2000 were included. To evaluate the impact of nodal metastases, the extent of lymphadenectomy was compared according to the number of nodes removed and positive nodes resected. Multivariable Cox regression and Kaplan-Meier survival curves were used for analysis. Results: The median number of nodes removed was 31 (pelvic, 21.5, and aortic, 10), and the median number of positive nodes was 5. The 5-year overall survival was 44.8%. On multivariate analysis, only the extent of peritoneal metastases before surgery was a significant factor for survival (P = 0.001 for stage IIIC and P = 0.004 for stage IV). Analysis of 83 patients with advanced peritoneal disease more than 2 cm demonstrated before debulking, removal of more than 40 lymph nodes was a significant prognostic factor for overall survival (hazard ratio, 0.52; P = 0.032; 95% confidence interval, 0.29-0.35). In 29 patients with advanced peritoneal disease and no residual disease after debulking, removal of more than 10 positive was a factor for survival. Conclusions: There was a survival benefit in patients with EOC with advanced peritoneal disease more than 2 cm before debulking when more than 40 lymph nodes were removed. There was an additional survival benefit in those patients with no residual disease after debulking when more than 10 positive nodes were removed.

Original languageEnglish (US)
Pages (from-to)987-992
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume22
Issue number6
DOIs
StatePublished - Jul 2012

Fingerprint

Lymph Node Excision
Peritoneal Diseases
Survival
Lymph Nodes
Neoplasm Metastasis
Kaplan-Meier Estimate
Ovarian epithelial cancer
Multivariate Analysis
Confidence Intervals

Keywords

  • Advanced epithelial ovarian cancer
  • Prognostic factors
  • Survival
  • Therapeutic role pelvic and aortic lymphadenectomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

The role of lymphadenectomy in node-positive epithelial ovarian cancer. / Pereira, Augusto; Pérez-Medina, Tirso; Magrina, Javier F.; Magtibay, Paul; Millan, Isabel; Iglesias, Enrique.

In: International Journal of Gynecological Cancer, Vol. 22, No. 6, 07.2012, p. 987-992.

Research output: Contribution to journalArticle

Pereira, Augusto ; Pérez-Medina, Tirso ; Magrina, Javier F. ; Magtibay, Paul ; Millan, Isabel ; Iglesias, Enrique. / The role of lymphadenectomy in node-positive epithelial ovarian cancer. In: International Journal of Gynecological Cancer. 2012 ; Vol. 22, No. 6. pp. 987-992.
@article{ef9805af404e4d7288b2a3a46a49608b,
title = "The role of lymphadenectomy in node-positive epithelial ovarian cancer",
abstract = "Objective: To evaluate the therapeutic role of pelvic and aortic lymphadenectomy in patients with epithelial ovarian cancer (EOC) and positive nodes (stages IIIC and IV). Methods: Retrospective chart review. Data from all consecutive patients with EOC and positive retroperitoneal lymph nodes (stage IIIC and IV) in Mayo Clinic from 1996 to 2000 were included. To evaluate the impact of nodal metastases, the extent of lymphadenectomy was compared according to the number of nodes removed and positive nodes resected. Multivariable Cox regression and Kaplan-Meier survival curves were used for analysis. Results: The median number of nodes removed was 31 (pelvic, 21.5, and aortic, 10), and the median number of positive nodes was 5. The 5-year overall survival was 44.8{\%}. On multivariate analysis, only the extent of peritoneal metastases before surgery was a significant factor for survival (P = 0.001 for stage IIIC and P = 0.004 for stage IV). Analysis of 83 patients with advanced peritoneal disease more than 2 cm demonstrated before debulking, removal of more than 40 lymph nodes was a significant prognostic factor for overall survival (hazard ratio, 0.52; P = 0.032; 95{\%} confidence interval, 0.29-0.35). In 29 patients with advanced peritoneal disease and no residual disease after debulking, removal of more than 10 positive was a factor for survival. Conclusions: There was a survival benefit in patients with EOC with advanced peritoneal disease more than 2 cm before debulking when more than 40 lymph nodes were removed. There was an additional survival benefit in those patients with no residual disease after debulking when more than 10 positive nodes were removed.",
keywords = "Advanced epithelial ovarian cancer, Prognostic factors, Survival, Therapeutic role pelvic and aortic lymphadenectomy",
author = "Augusto Pereira and Tirso P{\'e}rez-Medina and Magrina, {Javier F.} and Paul Magtibay and Isabel Millan and Enrique Iglesias",
year = "2012",
month = "7",
doi = "10.1097/IGC.0b013e318257b958",
language = "English (US)",
volume = "22",
pages = "987--992",
journal = "International Journal of Gynecological Cancer",
issn = "1048-891X",
publisher = "Wolters Kluwer Health",
number = "6",

}

TY - JOUR

T1 - The role of lymphadenectomy in node-positive epithelial ovarian cancer

AU - Pereira, Augusto

AU - Pérez-Medina, Tirso

AU - Magrina, Javier F.

AU - Magtibay, Paul

AU - Millan, Isabel

AU - Iglesias, Enrique

PY - 2012/7

Y1 - 2012/7

N2 - Objective: To evaluate the therapeutic role of pelvic and aortic lymphadenectomy in patients with epithelial ovarian cancer (EOC) and positive nodes (stages IIIC and IV). Methods: Retrospective chart review. Data from all consecutive patients with EOC and positive retroperitoneal lymph nodes (stage IIIC and IV) in Mayo Clinic from 1996 to 2000 were included. To evaluate the impact of nodal metastases, the extent of lymphadenectomy was compared according to the number of nodes removed and positive nodes resected. Multivariable Cox regression and Kaplan-Meier survival curves were used for analysis. Results: The median number of nodes removed was 31 (pelvic, 21.5, and aortic, 10), and the median number of positive nodes was 5. The 5-year overall survival was 44.8%. On multivariate analysis, only the extent of peritoneal metastases before surgery was a significant factor for survival (P = 0.001 for stage IIIC and P = 0.004 for stage IV). Analysis of 83 patients with advanced peritoneal disease more than 2 cm demonstrated before debulking, removal of more than 40 lymph nodes was a significant prognostic factor for overall survival (hazard ratio, 0.52; P = 0.032; 95% confidence interval, 0.29-0.35). In 29 patients with advanced peritoneal disease and no residual disease after debulking, removal of more than 10 positive was a factor for survival. Conclusions: There was a survival benefit in patients with EOC with advanced peritoneal disease more than 2 cm before debulking when more than 40 lymph nodes were removed. There was an additional survival benefit in those patients with no residual disease after debulking when more than 10 positive nodes were removed.

AB - Objective: To evaluate the therapeutic role of pelvic and aortic lymphadenectomy in patients with epithelial ovarian cancer (EOC) and positive nodes (stages IIIC and IV). Methods: Retrospective chart review. Data from all consecutive patients with EOC and positive retroperitoneal lymph nodes (stage IIIC and IV) in Mayo Clinic from 1996 to 2000 were included. To evaluate the impact of nodal metastases, the extent of lymphadenectomy was compared according to the number of nodes removed and positive nodes resected. Multivariable Cox regression and Kaplan-Meier survival curves were used for analysis. Results: The median number of nodes removed was 31 (pelvic, 21.5, and aortic, 10), and the median number of positive nodes was 5. The 5-year overall survival was 44.8%. On multivariate analysis, only the extent of peritoneal metastases before surgery was a significant factor for survival (P = 0.001 for stage IIIC and P = 0.004 for stage IV). Analysis of 83 patients with advanced peritoneal disease more than 2 cm demonstrated before debulking, removal of more than 40 lymph nodes was a significant prognostic factor for overall survival (hazard ratio, 0.52; P = 0.032; 95% confidence interval, 0.29-0.35). In 29 patients with advanced peritoneal disease and no residual disease after debulking, removal of more than 10 positive was a factor for survival. Conclusions: There was a survival benefit in patients with EOC with advanced peritoneal disease more than 2 cm before debulking when more than 40 lymph nodes were removed. There was an additional survival benefit in those patients with no residual disease after debulking when more than 10 positive nodes were removed.

KW - Advanced epithelial ovarian cancer

KW - Prognostic factors

KW - Survival

KW - Therapeutic role pelvic and aortic lymphadenectomy

UR - http://www.scopus.com/inward/record.url?scp=84863613557&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863613557&partnerID=8YFLogxK

U2 - 10.1097/IGC.0b013e318257b958

DO - 10.1097/IGC.0b013e318257b958

M3 - Article

C2 - 22706223

AN - SCOPUS:84863613557

VL - 22

SP - 987

EP - 992

JO - International Journal of Gynecological Cancer

JF - International Journal of Gynecological Cancer

SN - 1048-891X

IS - 6

ER -