Mesenteric lymph node involvement in advanced ovarian cancer patients undergoing rectosigmoid resection: Prognostic role and clinical considerations

Valerio Gallotta, Francesco Fanfani, Anna Fagotti, Vito Chiantera, Francesco Legge, Salvatore Gueli Alletti, Camilla Nero, Alessandro Pasquale Margariti, Valerio Papa, Sergio Alfieri, Francesca Ciccarone, Giovanni Scambia, Gabriella Ferrandina

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aim of this retrospective study was to investigate the incidence of mesenteric lymph node (MLN) involvement, and its prognostic role in advanced ovarian cancer (OC). Methods: OC patients undergoing rectosigmoid resection during primary debulking surgery or interval debulking surgery were recorded. Progression-free survival (PFS) and overall survival were calculated from the date of diagnosis to the date of relapse/progression, death of disease, or the date of last follow-up. Results: MLNs were detected in 102/148 cases (68.9 %); the rate of MLN involvement was 47.0 %. The percentage of metastatic MLNs was higher in cases with >5 MLNs removed compared with cases with ≤5 MLNs removed (62.7 % vs. 31.3 %; p = 0.0027). A progressive increase in the rate of metastatic MLNs was documented in association with depth of bowel infiltration (p = 0.026). Cases with metastatic MLNs experienced isolated celiac trunk or aortic lymph node recurrences more frequently than patients without MLN involvement (44.8 % vs. 10.7 %; p = 0.0008). PFS did not differ between cases with positive versus negative MLN involvement (2-year PFS = 31 % vs. 43 %; p = 0.58). Conclusion: OC patients undergoing rectosigmoid resection showed metastatic MLN involvement in 47.0 % of cases. Metastatic MLN status is associated with a high rate of isolated aortic and celiac trunk lymph node recurrences.

Original languageEnglish
Pages (from-to)2369-2375
Number of pages7
JournalAnnals of Surgical Oncology
Volume21
Issue number7
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Surgery
  • Oncology
  • Medicine(all)

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