The addition of lymphadenectomy to secondary cytoreductive surgery in comparison with bulky node resection in patients with recurrent ovarian cancer

Giorgio Bogani, Umberto Leone Roberti Maggiore, Valentina Chiappa, Antonino Ditto, Fabio Martinelli, Ilaria Sabatucci, Lavinia Mosca, Domenica Lorusso, Francesco Raspagliesi

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)319-324
Number of pages6
JournalInternational Journal of Gynecology and Obstetrics
Volume143
Issue number3
DOIs
Publication statusPublished - Dec 2018

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Lymph Node Excision
Ovarian Neoplasms
Recurrence
Survival
National Cancer Institute (U.S.)
Kaplan-Meier Estimate
Lymphatic Diseases
Survival Analysis
Italy
Cohort Studies
Survival Rate
Retrospective Studies
Regression Analysis

Keywords

  • Aged
  • Chronic Disease
  • Cytoreduction Surgical Procedures
  • Disease-Free Survival
  • Female
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Recurrence, Local/pathology
  • Ovarian Neoplasms/pathology
  • Reoperation
  • Retrospective Studies
  • Survival Rate

Cite this

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title = "The addition of lymphadenectomy to secondary cytoreductive surgery in comparison with bulky node resection in patients with recurrent ovarian cancer",
abstract = "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.",
keywords = "Aged, Chronic Disease, Cytoreduction Surgical Procedures, Disease-Free Survival, Female, Humans, Lymph Node Excision, Lymphatic Metastasis, Middle Aged, Neoplasm Recurrence, Local/pathology, Ovarian Neoplasms/pathology, Reoperation, Retrospective Studies, Survival Rate",
author = "Giorgio Bogani and {Leone Roberti Maggiore}, Umberto and Valentina Chiappa and Antonino Ditto and Fabio Martinelli and Ilaria Sabatucci and Lavinia Mosca and Domenica Lorusso and Francesco Raspagliesi",
note = "{\circledC} 2018 International Federation of Gynecology and Obstetrics.",
year = "2018",
month = "12",
doi = "10.1002/ijgo.12667",
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journal = "International Journal of Gynecology and Obstetrics",
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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 -