TY - JOUR
T1 - The addition of lymphadenectomy to secondary cytoreductive surgery in comparison with bulky node resection in patients with recurrent ovarian cancer
AU - Bogani, Giorgio
AU - Leone Roberti Maggiore, Umberto
AU - Chiappa, Valentina
AU - Ditto, Antonino
AU - Martinelli, Fabio
AU - Sabatucci, Ilaria
AU - Mosca, Lavinia
AU - Lorusso, Domenica
AU - Raspagliesi, Francesco
N1 - © 2018 International Federation of Gynecology and Obstetrics.
PY - 2018/12
Y1 - 2018/12
N2 - OBJECTIVE: To evaluate the role of full lymphadenectomy in patients with isolated nodal recurrence of ovarian cancer.METHODS: In a retrospective study, the data of women undergoing secondary cytoreduction at the National Cancer Institute, Milan, Italy, between January 1, 2001, and December 31, 2015, were collected and patients with isolated nodal recurrence were identified. Factors predicting for disease-free interval (DFI) and overall survival were estimated using Kaplan-Meier survival analysis and Cox regression analysis.RESULTS: Of the 199 consecutive patients whose data were collected, isolated nodal recurrence (defined as the presence of lymphatic disease) was observed in 35 women. Among this study cohort, lymphadenectomy and bulky node removal were performed in 11 (31%) and 24 (69%) patients, respectively. Women who underwent lymphadenectomy experienced better DFI compared with those who had bulky node removal only (median 21 and 12 months, respectively; P=0.019), and lymphadenectomy, but not bulky node removal, significantly improved rates of DFI (P=0.043). No factors were independently associated with overall survival; however, a trend toward an improved overall survival rate was observed in patients undergoing complete resection at the time of primary surgery (P=0.055).CONCLUSION: Lymphadenectomy at the time of secondary cytoreduction improved DFI but did not have a significant effect on overall survival.
AB - OBJECTIVE: To evaluate the role of full lymphadenectomy in patients with isolated nodal recurrence of ovarian cancer.METHODS: In a retrospective study, the data of women undergoing secondary cytoreduction at the National Cancer Institute, Milan, Italy, between January 1, 2001, and December 31, 2015, were collected and patients with isolated nodal recurrence were identified. Factors predicting for disease-free interval (DFI) and overall survival were estimated using Kaplan-Meier survival analysis and Cox regression analysis.RESULTS: Of the 199 consecutive patients whose data were collected, isolated nodal recurrence (defined as the presence of lymphatic disease) was observed in 35 women. Among this study cohort, lymphadenectomy and bulky node removal were performed in 11 (31%) and 24 (69%) patients, respectively. Women who underwent lymphadenectomy experienced better DFI compared with those who had bulky node removal only (median 21 and 12 months, respectively; P=0.019), and lymphadenectomy, but not bulky node removal, significantly improved rates of DFI (P=0.043). No factors were independently associated with overall survival; however, a trend toward an improved overall survival rate was observed in patients undergoing complete resection at the time of primary surgery (P=0.055).CONCLUSION: Lymphadenectomy at the time of secondary cytoreduction improved DFI but did not have a significant effect on overall survival.
KW - Aged
KW - Chronic Disease
KW - Cytoreduction Surgical Procedures
KW - Disease-Free Survival
KW - Female
KW - Humans
KW - Lymph Node Excision
KW - Lymphatic Metastasis
KW - Middle Aged
KW - Neoplasm Recurrence, Local/pathology
KW - Ovarian Neoplasms/pathology
KW - Reoperation
KW - Retrospective Studies
KW - Survival Rate
U2 - 10.1002/ijgo.12667
DO - 10.1002/ijgo.12667
M3 - Article
C2 - 30194778
VL - 143
SP - 319
EP - 324
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
SN - 0020-7292
IS - 3
ER -