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

DC Field Value Language
dc.contributor.authorChang, SJ-
dc.contributor.authorBristow, RE-
dc.contributor.authorRyu, HS-
dc.date.accessioned2013-04-29T01:57:23Z-
dc.date.available2013-04-29T01:57:23Z-
dc.date.issued2012-
dc.identifier.issn0090-8258-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/8053-
dc.description.abstractOBJECTIVE: 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, p<0.01). In patients with no gross residual disease (NGR) or residual disease 0.1-1cm (GR-1), the median OS time of those who had lymphadenectomy was significantly longer than those who did not (86 versus 46 months, p=0.02). However, in patients with residual disease >1cm (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.
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dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAntineoplastic Combined Chemotherapy Protocols-
dc.subject.MESHAorta-
dc.subject.MESHCarboplatin-
dc.subject.MESHCarcinoma-
dc.subject.MESHChemotherapy, Adjuvant-
dc.subject.MESHCisplatin-
dc.subject.MESHDisease-Free Survival-
dc.subject.MESHFallopian Tube Neoplasms-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHLymph Node Excision-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNeoplasm Grading-
dc.subject.MESHNeoplasm, Residual-
dc.subject.MESHOvarian Neoplasms-
dc.subject.MESHPaclitaxel-
dc.subject.MESHPelvis-
dc.subject.MESHPeritoneal Neoplasms-
dc.subject.MESHProportional Hazards Models-
dc.subject.MESHRetrospective Studies-
dc.titlePrognostic significance of systematic lymphadenectomy as part of primary debulking surgery in patients with advanced ovarian cancer-
dc.typeArticle-
dc.identifier.pmid22609747-
dc.identifier.urlhttp://linkinghub.elsevier.com/retrieve/pii/S0090-8258(12)00358-7-
dc.contributor.affiliatedAuthor장, 석준-
dc.contributor.affiliatedAuthor유, 희석-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.ygyno.2012.05.014-
dc.citation.titleGynecologic oncology-
dc.citation.volume126-
dc.citation.number3-
dc.citation.date2012-
dc.citation.startPage381-
dc.citation.endPage386-
dc.identifier.bibliographicCitationGynecologic oncology, 126(3). : 381-386, 2012-
dc.identifier.eissn1095-6859-
dc.relation.journalidJ000908258-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Obstetrics & Gynecology
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