Prognostic impact of celiac lymph node involvement in patients after frontline treatment for advanced ovarian cancer

Completeness of cytoreduction is the most important prognostic factor in patients with advanced ovarian cancer (OC). Extensive upper abdominal surgery has allowed to increase the rate complete cytoreduction and the feasibility of resection of celiac lymph nodes (CLN) and porta hepatis disease in the...

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Bibliographic Details
Published in:European journal of surgical oncology 2019-08, Vol.45 (8), p.1410-1416
Main Authors: Angeles, Martina Aida, Ferron, Gwénaël, Cabarrou, Bastien, Balague, Gisèle, Martínez-Gómez, Carlos, Gladieff, Laurence, Pomel, Christophe, Martinez, Alejandra
Format: Article
Language:English
Subjects:
Advanced epithelial ovarian cancer
Cancer
Celiac lymph node status
Life Sciences
Peritoneal ovarian carcinomatosis
Porta hepatis disease
Upper abdominal procedures
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Summary:Completeness of cytoreduction is the most important prognostic factor in patients with advanced ovarian cancer (OC). Extensive upper abdominal surgery has allowed to increase the rate complete cytoreduction and the feasibility of resection of celiac lymph nodes (CLN) and porta hepatis disease in these patients has been demonstrated. The aim of our study was to assess the prognostic impact of CLN involvement in patients with primary advanced OC undergoing a complete cytoreductive surgery (CRS). We designed a retrospective unicentric study. We reviewed data from patients who underwent CLN resection with or without porta hepatis disease resection, within upfront or interval complete CRS in the frontline treatment of advanced epithelial OC between January 2008 and December 2015. Patients were classified in two groups according to CLN status. Univariate and multivariate analyses were conducted. Survival rates were estimated using Kaplan-Meier method. Forty-three patients were included and positive CLN were found in 39.5% of them. The median disease-free survival in the group of patients with positive and negative CLN were 11.3 months and 25.8 months, respectively. In multivariable analysis, both CLN involvement and high peritoneal cancer index were independently associated with decreased disease-free survival. Computed tomography re-reading by an expert radiologist has good sensitivity for detection of positive CLN. CLN involvement and high preoperative tumor burden are independently associated with decreased survival after complete cytoreduction for OC. CLN involvement is a marker of diffuse disease and an independent risk factor for early recurrent disease.
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2019.02.018