Published in:
01-08-2015 | Original Article – Clinical Oncology
RETRACTED ARTICLE: The prognostic relevance of node metastases in optimally cytoreduced advanced ovarian cancer
Published in: Journal of Cancer Research and Clinical Oncology | Issue 8/2015
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Purpose
To delineate the relevance of pelvic and para-aortic node involvement in
optimally cytoreduced (residual tumour <1 cm) stage IIIC ovarian cancer
patients.
Methods
Ninety-five consecutive optimally cytoreduced (R ≤ 1 cm) patients with primary stage IIIc ovarian cancer
underwent stage-related surgery and got adjuvant platinum-based chemotherapy.
Median follow-up: 53.5 months. All patients got systematic lymphadenectomy. On
average, 24.7 pelvic and para-aortic lymph nodes were removed per patient (range
1–60 nodes). Patients were stratified into three groups to evaluate node
involvement (ratio: affected to resected nodes): (1) (=0); (2) (>0–≤0.5)
>0 and ≤50 % of affected nodes; (3) (>0.5–≤1) >50 % of affected nodes.
Clinical parameters were retrospectively evaluated. Kaplan–Meier survival curve
was used to evaluate the prognostic value.
Results
Most often serous histology, histologic grade 3 and a node ratio >0–≤0.5
(61.1 %) were detected. Complete cytoreduction (R = 0 mm) has significant best prognostic impact compared to
R > 0 mm–1 cm (OS: p = 0.047, PFS: p = 0.00). Node involvement was associated with serous histology
and grade 3. Increasing node ratio leads to significant decreased OS (p = 0.019) and significant best OS was associated
with node ratio >0–≤0.5.
Conclusions
The goal is optimal cytoreduction in advanced ovarian cancer. More extensive
lymphadenectomy seems to play an important role in providing an accurate
staging, and the node ratio might give prognostic information. Current
prospective studies like the LION study (AGO-Ovar) had to investigate if these
data have therapeutic implications and may be considered in future
staging.