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01-05-2020 | Ovarian Cancer | Gynecologic Oncology

Significance of lymph node ratio on survival of women with borderline ovarian tumors

Authors: David J. Nusbaum, Rachel S. Mandelbaum, Hiroko Machida, Shinya Matsuzaki, Lynda D. Roman, Anil K. Sood, David M. Gershenson, Koji Matsuo

Published in: Archives of Gynecology and Obstetrics | Issue 5/2020

Abstract

Purpose

To assess the qualitative and quantitative measures of the effect of pelvic lymph node involvement on survival of women with borderline ovarian tumors (BOTs).

Methods

This is a retrospective study examining the Surveillance, Epidemiology, and End Results Program between 1988 and 2003. Women with stage T1-3 BOTs who had results of pelvic lymph node status at surgery were included. The effect of lymph node involvement on cause-specific survival (CSS) was evaluated using multivariable analysis with the following approaches: (1) any involvement, (2) involvement of multiple nodes (≥ 2 nodes), and (3) lymph node ratio (LNR), defined as the ratio of the number of tumor-containing lymph nodes to the total number of harvested lymph nodes.

Results

A total of 1524 women were examined for analysis. Median count of sampled nodes was 8 (interquartile range 3–15), and there were 81 (5.3%, 95% confidence interval [CI] 4.2–6.4) women who had lymph node involvement. Median follow-up was 15.8 (interquartile range 13.8–18.9) years, and 83 (5.4%) women died of BOTs. After controlling for age, histology, stage, and tumor size, only LNR remained an independent prognostic factor for decreased CSS (adjusted hazard ratio [HR] per percentage unit 1.015, 95% CI 1.003–1.026, P = 0.014), whereas any involvement (adjusted HR 1.700, 95% CI 0.843–3.430, P = 0.138) and involvement of multiple nodes (adjusted HR 1.644, 95% CI 0.707–3.823, P = 0.249) did not. On cutoff analysis, LNR ≥ 13% had the largest magnitude of significance on multivariable analysis of CSS (adjusted HR 2.399, 95% CI 1.163–4.947, P = 0.018).

Conclusion

Our study suggests that high pelvic LNR may be a prognostic factor associated with decreased CSS in women with BOTs.

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Title: Significance of lymph node ratio on survival of women with borderline ovarian tumors
Authors: David J. Nusbaum
Rachel S. Mandelbaum
Hiroko Machida
Shinya Matsuzaki
Lynda D. Roman
Anil K. Sood
David M. Gershenson
Koji Matsuo
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Ovarian Cancer
Ovarian Cancer
Lymphadenectomy
Published in: Archives of Gynecology and Obstetrics / Issue 5/2020
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-020-05535-0

At a glance: The STEP trials

Springer Medicine

Significance of lymph node ratio on survival of women with borderline ovarian tumors

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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