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

Suk Joon Chang, Robert E. Bristow, Hee Sug Ryu

Research output: Contribution to journalArticlepeer-review

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, p < 0.01). In patients with no gross residual disease (NGR) or residual disease 0.1-1 cm (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 > 1 cm (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.

Original languageEnglish (US)
Pages (from-to)381-386
Number of pages6
JournalGynecologic oncology
Volume126
Issue number3
DOIs
StatePublished - Sep 1 2012

Keywords

  • Advanced ovarian cancer
  • Lymphadenectomy
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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