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Clinicopathological factors of pelvic lymph nodes involvement in advanced serous ovarian cancer
Affiliations- Department of Gynecologic Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, Poland
- Department of Gynecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, Warsaw
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Abstract
Objectives: Retroperitoneal lymph nodes metastases occur frequently in patients with ovarian cancer. Lymphadenectomy
increases risk of perioperative complications. In clinical practice to reduce rate of complications aortocaval lymphadenectomy
is omitted and solely resection of pelvic lymph nodes is performed. To establish factors affecting metastases to pelvic
lymph nodes in advanced ovarian cancer.
Material and methods: A retrospective study among patients with serous advanced ovarian cancer (FIGO IIIB–IVB) was
conducted at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw and Department of Gynecologic
Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw. All patients underwent
surgical treatment including pelvic lymphadenectomy between 2014 and 2017. Data including age, body mass index
(BMI), pretreatment CA125 serum level, tumor volume, grading, one-/both-sided tumor, menopausal status, ascites were
analysed as possible factors influencing the pelvic lymph nodes involvement. The statistical analysis was performed with
Python software.
Results: 87 consecutive patients were eligible for the study. Metastases to pelvic lymph nodes were found in 29 (33.33%)
patients. Pretreatment serum CA-125 concentration (652 U/mL vs 360.9 U/mL, p < 0.05) and high grade histology corresponded
with pelvic nodal involvement.
Conclusions: The knowledge of factors influencing metastases to pelvic lymph nodes may help clinicians in proper counselling
and tailoring of therapy.
Abstract
Objectives: Retroperitoneal lymph nodes metastases occur frequently in patients with ovarian cancer. Lymphadenectomy
increases risk of perioperative complications. In clinical practice to reduce rate of complications aortocaval lymphadenectomy
is omitted and solely resection of pelvic lymph nodes is performed. To establish factors affecting metastases to pelvic
lymph nodes in advanced ovarian cancer.
Material and methods: A retrospective study among patients with serous advanced ovarian cancer (FIGO IIIB–IVB) was
conducted at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw and Department of Gynecologic
Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw. All patients underwent
surgical treatment including pelvic lymphadenectomy between 2014 and 2017. Data including age, body mass index
(BMI), pretreatment CA125 serum level, tumor volume, grading, one-/both-sided tumor, menopausal status, ascites were
analysed as possible factors influencing the pelvic lymph nodes involvement. The statistical analysis was performed with
Python software.
Results: 87 consecutive patients were eligible for the study. Metastases to pelvic lymph nodes were found in 29 (33.33%)
patients. Pretreatment serum CA-125 concentration (652 U/mL vs 360.9 U/mL, p < 0.05) and high grade histology corresponded
with pelvic nodal involvement.
Conclusions: The knowledge of factors influencing metastases to pelvic lymph nodes may help clinicians in proper counselling
and tailoring of therapy.
Keywords
ovarian cancer; metastasis to pelvic lymph node, clinicopathological factors
About this articleTitle
Clinicopathological factors of pelvic lymph nodes involvement in advanced serous ovarian cancer
Journal
Issue
Article type
Research paper
Pages
68-72
Published online
2020-02-28
Page views
1740
Article views/downloads
1030
DOI
Pubmed
Bibliographic record
Ginekol Pol 2020;91(2):68-72.
Keywords
ovarian cancer
metastasis to pelvic lymph node
clinicopathological factors
Authors
Szymon Piatek
Ksawery Golawski
Grzegorz Panek
Mariusz Bidzinski
Miroslaw Wielgos
References (26)- Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6): 394–424.
- IARC. Encyclopedia of Cancer. : 1475–1475.
- Prat J. FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. 2014; 124(1): 1–5.
- Morice P, Joulie F, Camatte S, et al. Lymph node involvement in epithelial ovarian cancer: analysis of 276 pelvic and paraaortic lymphadenectomies and surgical implications. J Am Coll Surg. 2003; 197(2): 198–205.
- Kim HS, Park NH, Chung HH, et al. Significance of preoperative serum CA-125 levels in the prediction of lymph node metastasis in epithelial ovarian cancer. Acta Obstet Gynecol Scand. 2008; 87(11): 1136–1142.
- Harter P, Sehouli J, Lorusso D, et al. A Randomized Trial of Lymphadenectomy in Patients with Advanced Ovarian Neoplasms. New England Journal of Medicine. 2019; 380(9): 822–832.
- Panici PB, Maggioni A, Hacker N, et al. Systematic aortic and pelvic lymphadenectomy versus resection of bulky nodes only in optimally debulked advanced ovarian cancer: a randomized clinical trial. J Natl Cancer Inst. 2005; 97(8): 560–566.
- Zhou J, Sun JY, Wu SG, et al. Risk factors for lymph node metastasis in ovarian cancer: Implications for systematic lymphadenectomy. International Journal of Surgery. 2016; 29: 123–127.
- Powless CA, Aletti GD, Bakkum-Gamez JN, et al. Risk factors for lymph node metastasis in apparent early-stage epithelial ovarian cancer: implications for surgical staging. Gynecol Oncol. 2011; 122(3): 536–540.
- Kleppe M, Kraima AC, Kruitwagen RF, et al. Understanding Lymphatic Drainage Pathways of the Ovaries to Predict Sites for Sentinel Nodes in Ovarian Cancer. Int J Gynecol Cancer. 2015; 25(8): 1405–1414.
- Burghardt E, Girardi F, Lahousen M, et al. Patterns of pelvic and paraaortic lymph node involvement in ovarian cancer. Gynecol Oncol. 1991; 40(2): 103–106.
- Bachmann C, Bachmann R, Kraemer B, et al. Prevalence and distribution pattern of nodal metastases in advanced ovarian cancer. Mol Clin Oncol. 2016; 5(4): 483–487.
- Bachmann C, Krämer B, Brucker SY, et al. Relevance of pelvic and para-aortic node metastases in early-stage ovarian cancer. Anticancer Res. 2014; 34(11): 6735–6738.
- Fournier M, Stoeckle E, Guyon F, et al. Lymph node involvement in epithelial ovarian cancer: sites and risk factors in a series of 355 patients. Int J Gynecol Cancer. 2009; 19(8): 1307–1313.
- Powless CA, Aletti GD, Bakkum-Gamez JN, et al. Risk factors for lymph node metastasis in apparent early-stage epithelial ovarian cancer: implications for surgical staging. Gynecol Oncol. 2011; 122(3): 536–540.
- Bachmann C, Bachmann R, Fend F, et al. Incidence and Impact of Lymph Node Metastases in Advanced Ovarian Cancer: Implications for Surgical Treatment. Journal of Cancer. 2016; 7(15): 2241–2246.
- Aletti GD, Dowdy S, Podratz KC, et al. Role of lymphadenectomy in the management of grossly apparent advanced stage epithelial ovarian cancer. Am J Obstet Gynecol. 2006; 195(6): 1862–1868.
- Roger N, Zafrani Y, Uzan C, et al. Should Pelvic and Para-aortic Lymphadenectomy Be Different Depending on Histological Subtype in Epithelial Ovarian Cancer? Annals of Surgical Oncology. 2007; 15(1): 333–338.
- Onda T, Yoshikawa H, Yokota H, et al. Assessment of metastases to aortic and pelvic lymph nodes in epithelial ovarian carcinoma. A proposal for essential sites for lymph node biopsy. Cancer. 1996; 78(4): 803–808.
- Baiocchi G, Raspagliesi F, Grosso G, et al. Early ovarian cancer: Is there a role for systematic pelvic and para-aortic lymphadenectomy? International Journal of Gynecological Cancer. 1998; 8(2): 103–108.
- Takeshima N, Hirai Y, Umayahara K, et al. Lymph node metastasis in ovarian cancer: difference between serous and non-serous primary tumors. Gynecol Oncol. 2005; 99(2): 427–431.
- Ditto A, Martinelli F, Reato C, et al. Systematic para-aortic and pelvic lymphadenectomy in early stage epithelial ovarian cancer: a prospective study. Ann Surg Oncol. 2012; 19(12): 3849–3855.
- Bachmann C, Brucker SY, Kraemer B, et al. The prognostic relevance of node metastases in optimally cytoreduced advanced ovarian cancer. J Cancer Res Clin Oncol. 2015; 141(8): 1475–1480.
- Kleppe M, Wang T, Van Gorp T, et al. Lymph node metastasis in stages I and II ovarian cancer: a review. Gynecol Oncol. 2011; 123(3): 610–614.
- Tsumura N, Sakuragi N, Hareyama H, et al. Distribution pattern and risk factors of pelvic and para-aortic lymph node metastasis in epithelial ovarian carcinoma. Int J Cancer. 1998; 79(5): 526–530.
- Sudolmuş S, Köroğlu N, Yıldırım G, et al. Can CA-125 predict lymph node metastasis in epithelial ovarian cancers in Turkish population? Dis Markers. 2014; 2014: 492537.
