The Importance of Comprehensive Surgical Staging Including Para-Aortic Lymph Node Dissection of Presumed Early Stage Epithelial Ovarian Cancer: A Contemporary Prospective Evaluation

2017 ◽  
Vol 33 (5) ◽  
pp. 184-188
Author(s):  
Ramana Reddy Naru ◽  
Narendra Hulikal ◽  
Rukmangadha Nandyal ◽  
Vijayalkshmidevi Bodagala
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Epithelial Ovarian Cancer ◽  
Lymph Node Dissection ◽  
Early Stage ◽  
Surgical Staging ◽  
Prospective Evaluation ◽  
Node Dissection ◽  
Aortic Lymph Node

scholarly journals Systematic Lymph Node Dissection May Be Abolished in Patients With Apparent Early-Stage Low-Grade Mucinous and Endometrioid Epithelial Ovarian Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiayu Chen ◽  
Jie Yin ◽  
Yan Li ◽  
Yu Gu ◽  
Wei Wang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Epithelial Ovarian Cancer ◽  
Lymph Node Dissection ◽  
Early Stage ◽  
Progression Free Survival ◽  
Low Grade ◽  
Node Dissection ◽  
Surgical Methods ◽  
Systematic Lymph Node Dissection

ObjectiveTo investigate whether systematic lymph node dissection can confer clinical benefits in patients with apparent early-stage low-grade epithelial ovarian cancer.MethodsPatients with apparent early-stage low-grade epithelial ovarian cancer seen at Peking Union Medical College Hospital from January 1, 2005, to December 31, 2015, were retrospectively enrolled. Patients with other histological types and those who did not receive necessary adjuvant chemotherapy were excluded. Data collection and long-term follow-up were performed. According to the removed lymph node number, three groups based on surgical methods were used: abnormal lymph node resection, pelvic lymphadenectomy, and systematic lymph node dissection to control surgical quality. Their effects on prognosis were analyzed in pathological subgroups.ResultsA total of 196 patients were enrolled; 30.1% of patients had serous, 42.3% of patients had mucinous, and 27.6% of patients had endometrioid carcinoma, of which 51 (26.0%), 96 (49.0), and 49 (25.0%) patients were treated with the above surgical methods, respectively. The occult lymph node metastasis rate was 14 (7.1%), and only five (2.6%) of apparent early-stage patients were upstaged due to lymph node metastasis alone. Systematic lymph node dissection did not benefit progression-free survival or disease-specific overall survival of apparent early-stage low-grade mucinous and endometrioid epithelial ovarian cancer but prolonged progression-free survival of apparent early-stage low-grade serous patients (OR, 0.231, 95% CI, 0.080, 0.668, p = 0.007).ConclusionsSystematic lymph node dissection may be abolished in patients with apparent early-stage low-grade mucinous and endometrioid epithelial ovarian cancer but may be considered for apparent early-stage low-grade serous patients.

scholarly journals Clinical Impact of Lymphadenectomy after Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer: A Review of Available Data

2021 ◽  
Vol 10 (2) ◽  
pp. 334
Author(s):  
Stephanie Seidler ◽  
Meriem Koual ◽  
Guillaume Achen ◽  
Enrica Bentivegna ◽  
Laure Fournier ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Lymph Node Dissection ◽  
Prospective Trial ◽  
Node Dissection ◽  
Advanced Epithelial Ovarian Cancer ◽  
The Impact ◽  
Systematic Lymph Node Dissection

Recent robust data allow for omitting lymph node dissection for patients with advanced epithelial ovarian cancer (EOC) and without any suspicion of lymph node metastases, without compromising recurrence-free survival (RFS), nor overall survival (OS), in the setting of primary surgical treatment. Evidence supporting the same postulate for patients undergoing complete cytoreductive surgery after neoadjuvant chemotherapy (NACT) is lacking. Throughout a systematic literature review, the aim of our study was to evaluate the impact of lymph node dissection in patients undergoing surgery for advanced-stage EOC after NACT. A total of 1094 patients, included in six retrospective series, underwent either systematic, selective or no lymph node dissection. Only one study reveals a positive effect of lymphadenectomy on OS, and two on RFS. The four remaining series fail to demonstrate any beneficial effect on survival, neither for RFS nor OS. All of them highlight the higher peri- and post-operative complication rate associated with systematic lymph node dissection. Despite heterogeneity in the design of the studies included, there seems to be a trend showing no improvement on OS for systematic lymph node dissection in node negative patients. A well-conducted prospective trial is mandatory to evaluate this matter.

Incidence of Lymph Node Metastases in Apparent Early-Stage Low-Grade Epithelial Ovarian Cancer: A Comprehensive Review

2016 ◽  
Vol 26 (8) ◽  
pp. 1407-1414 ◽  
Author(s):  
Victor Lago ◽  
Lucas Minig ◽  
Christina Fotopoulou
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Epithelial Ovarian Cancer ◽  
Retrospective Studies ◽  
Early Stage ◽  
Stage I ◽  
Surgical Staging ◽  
Low Grade ◽  
Early Stage Disease ◽  
True Incidence

ObjectivesThis study aimed to determine the incidence of lymph node (LN) metastases in presumed stage I-II low-grade epithelial ovarian cancer (EOC).MethodsEligible studies were identified from MEDLINE and EMBASE (time frame, 2015–1975), that analyzed patients with clinical or radiologic presumed early-stage EOC who underwent a complete pelvic and para-aortic lymphadenectomy as part of their surgical staging. The number and site of dissected and involved LNs and the correlation with overall outcome are analyzed. The termlow gradeand also the older termwell differentiatedwere used.ResultsThirteen of 978 identified studies were selected, and 13 of 75 studies were identified as eligible. A total of 1403 patients were analyzed in these 13 retrospective studies. The final International Federation of Gynecology and Obstetrics staging after completed surgical staging was I to II in 912 patients (65%). A total of 338 patients (24%) had grade 1 tumors whereas 473 patients (34%) had grade 2, and 502 patients (36%) had grade 3 tumors. Systematic lymphadenectomy was performed in 1159 patients (83%), whereof 1142 (82%) were pelvic and para-aortic LN dissections.In 185 patients (13%), an upstaging from an apparent clinical stage I-II to IIIC occurred because of LN involvement: 64 (35%) of the patients had only pelvic LNs metastases, 69 (37%) had only para-aortic LNs metastasis, and 51 (28%) had both a pelvic and para-aortic LN involvement. When analyzing only the patients with low-grade (grade 1 as the old classification) presumed early-stage disease (n = 273), only 8 patients (2.9%; range, 0–6.2) were identified with LNs metastases present.ConclusionsThe incidence of occult LN metastases in apparent early-stage low-grade EOC is 2.9% in a metaanalysis of retrospective studies. Future larger-scale prospectively assessed studies with established surgical quality of the LN dissection are warranted to establish the true incidence of LN metastasis in presumed early low-grade disease.

Clinical significance of para-aortic lymph node dissection and prognosis in ovarian cancer

2014 ◽  
Vol 8 (1) ◽  
pp. 96-100 ◽  
Author(s):  
Xianxian Li ◽  
Hui Xing ◽  
Lin Li ◽  
Yanli Huang ◽  
Min Zhou ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Clinical Significance ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Aortic Lymph Node

scholarly journals The impact of lymph node dissection on survival in patients with clinical early-stage ovarian cancer

2021 ◽  
Vol 32 ◽  
Author(s):  
Ting Deng ◽  
Qidan Huang ◽  
Ting Wan ◽  
Xiaoling Luo ◽  
Yanling Feng ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Early Stage ◽  
Node Dissection ◽  
The Impact ◽  
Early Stage Ovarian Cancer

Risk factors for lymph node metastasis in apparent early-stage epithelial ovarian cancer: Implications for surgical staging

2011 ◽  
Vol 122 (3) ◽  
pp. 536-540 ◽  
Author(s):  
Cecelia A. Powless ◽  
Giovanni D. Aletti ◽  
Jamie N. Bakkum-Gamez ◽  
William A. Cliby
Keyword(s):  
Risk Factors ◽  
Ovarian Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Epithelial Ovarian Cancer ◽  
Early Stage ◽  
Surgical Staging ◽  
Node Metastasis
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