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Research paper
Published online: 2021-04-26
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The insolvable problem; survival effect of lymphadenectomy in advanced stage ovarian cancer

Mehmet Sait Bakır, Özer Birge, Ceyda Karadag, Selen Doğan, Hasan Aykut Tuncer, Tayup Simsek
DOI: 10.5603/GP.a2021.0073
·
Pubmed: 33914302

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2021-04-26

Abstract

Objectives: In this study, we aimed to evaluate the effect of systemic lymphadenectomy on overall and progression free survival in advanced stage of ovarian cancer.

Material and methods: The data of ovarian cancer patients who had been admitted to our clinic between March 2008 and December 2019 were collected retrospectively. The patients who had received neo-adjuvant chemotherapy (NACT), those having undergone interval surgery, those who had non-epithelial ovarian cancer, those with residual tumour larger than 1 cm and those with stage I-IIA were excluded from the study.

Results: A total of 241 patients with inclusion criteria were included in the study. While 169 patients (70.1%) had undergone systemic lymphadenectomy (SLND), 72 (29.9%) had not. Lymph node involvement was present in 105 out of 169 patients (62.1%) who had undergone SLND. There was no statistically significant difference between the groups in terms of SLND and lymph node involvement for both progression free survival (PFS) and overall survival (OS) (p = 0.577, p = 0.493, p = 0.481, p = 0.849 respectively). When subgroup analysis was performed according to the residual tumor amount, we could not find any statistically significant difference in both PFS and OS in terms of SLND and lymph node involvement in R0 (complete resection) group (p = 0.057, p = 0.917, p = 0.106 and p = 0.980 respectively). We found similar results for patients in the R1 (optimal resection) group.

Conclusions: It was found that performing systemic lymphadenectomy had no effect on both progressive and overal survival. It should be kept in mind that the increasing number of malignant lymph nodes removed could have a therapeutic effect in OS. Large numbers of randomized clinical trials are required to enlighten this debatable issue that has been continuing, particularly in the recent two decades.

Abstract

Objectives: In this study, we aimed to evaluate the effect of systemic lymphadenectomy on overall and progression free survival in advanced stage of ovarian cancer.

Material and methods: The data of ovarian cancer patients who had been admitted to our clinic between March 2008 and December 2019 were collected retrospectively. The patients who had received neo-adjuvant chemotherapy (NACT), those having undergone interval surgery, those who had non-epithelial ovarian cancer, those with residual tumour larger than 1 cm and those with stage I-IIA were excluded from the study.

Results: A total of 241 patients with inclusion criteria were included in the study. While 169 patients (70.1%) had undergone systemic lymphadenectomy (SLND), 72 (29.9%) had not. Lymph node involvement was present in 105 out of 169 patients (62.1%) who had undergone SLND. There was no statistically significant difference between the groups in terms of SLND and lymph node involvement for both progression free survival (PFS) and overall survival (OS) (p = 0.577, p = 0.493, p = 0.481, p = 0.849 respectively). When subgroup analysis was performed according to the residual tumor amount, we could not find any statistically significant difference in both PFS and OS in terms of SLND and lymph node involvement in R0 (complete resection) group (p = 0.057, p = 0.917, p = 0.106 and p = 0.980 respectively). We found similar results for patients in the R1 (optimal resection) group.

Conclusions: It was found that performing systemic lymphadenectomy had no effect on both progressive and overal survival. It should be kept in mind that the increasing number of malignant lymph nodes removed could have a therapeutic effect in OS. Large numbers of randomized clinical trials are required to enlighten this debatable issue that has been continuing, particularly in the recent two decades.

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Keywords

ovarian cancer; lymphadenectomy; residual tumour; lymph node count

About this article
Title

The insolvable problem; survival effect of lymphadenectomy in advanced stage ovarian cancer

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-04-26

DOI

10.5603/GP.a2021.0073

Pubmed

33914302

Keywords

ovarian cancer
lymphadenectomy
residual tumour
lymph node count

Authors

Mehmet Sait Bakır
Özer Birge
Ceyda Karadag
Selen Doğan
Hasan Aykut Tuncer
Tayup Simsek

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