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Prognostic significance of systematic lymphadenectomy as part of primary debulking surgery in patients with advanced ovarian cancer

Authors
Chang, SJ; Bristow, RE; Ryu, HS
Citation
Gynecologic oncology, 126(3):381-386, 2012
Journal Title
Gynecologic oncology
ISSN
0090-82581095-6859
Abstract
OBJECTIVE: The objective of this study was to evaluate the impact of systematic pelvic and para-aortic lymphadenectomy on survival in patients with advanced ovarian cancer.



METHODS: We retrospectively analyzed the data of 189 consecutive patients with FIGO stage IIIC ovarian cancer between 2000 and 2011, who underwent primary cytoreductive surgery followed by platinum- and taxane-based chemotherapy. All patients were classified into two groups - patients who underwent systematic pelvic and para-aortic lymphadenectomy and those who did not. Progression-free (PFS) and overall survival (OS) times were analyzed using Kaplan-Meier method and Cox proportional hazards model.



RESULTS: Patients who underwent systematic lymphadenectomy had significantly improved PFS (22 versus 9 months, p<0.01) and OS (66 versus 40 months, p1cm (GR-B), there was no significant difference in OS according to lymphadenectomy (39 versus 40 months, p=0.50). Among patients with NGR, the median OS time of those who underwent systematic lymphadenectomy was significantly longer than those who did not undergo lymphadenectomy (not yet reached [>96] and 56 months, p<0.01). No significant difference of OS between patients with and without lymphadenectomy was observed in the subgroup of patients with GR-1 (50 versus 38 months, p=0.44). The performance of lymphadenectomy was a statistically significant and independent predictor of improved OS in addition to the status of residual disease and the performance of radical cytoreductive procedures (hazard ratio, 0.34; [95% CI, 0.23-0.52]; p<0.01).



CONCLUSIONS: Systematic lymphadenectomy may have a therapeutic value and be significantly associated with improved survival in stage IIIC ovarian cancer patients with grossly no visible residual disease.
MeSH terms
AdultAgedAntineoplastic Combined Chemotherapy Protocols/therapeutic useAortaCarboplatin/administration & dosageCarcinoma/drug therapy/pathology/*surgeryChemotherapy, AdjuvantCisplatin/administration & dosageDisease-Free SurvivalFallopian Tube Neoplasms/drug therapy/pathology/*surgeryFemaleHumansKaplan-Meier Estimate*Lymph Node ExcisionMiddle AgedNeoplasm GradingNeoplasm, ResidualOvarian Neoplasms/drug therapy/pathology/*surgeryPaclitaxel/administration & dosagePelvisPeritoneal Neoplasms/drug therapy/pathology/*surgeryProportional Hazards ModelsRetrospective Studies
DOI
10.1016/j.ygyno.2012.05.014
PMID
22609747
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Obstetrics & Gynecology
AJOU Authors
장, 석준유, 희석
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