Deep epigastric lymph nodes implication in patients' recurrence pattern after cytoreductive surgery in ovarian peritoneal metastases.

Autor: El Asmar A; Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Rue Meylemeersch 90, 1070, Brussels, Belgium. Electronic address: antoine.el.asmar@gmail.com., Vouche M; Department of Radiology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Rue Meylemeersch 90, 1070, Brussels, Belgium., Pop F; Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Rue Meylemeersch 90, 1070, Brussels, Belgium., Polastro L; Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Rue Meylemeersch 90, 1070, Brussels, Belgium., Chintinne M; Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Rue Meylemeersch 90, 1070, Brussels, Belgium., Veys I; Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Rue Meylemeersch 90, 1070, Brussels, Belgium., Donckier V; Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Rue Meylemeersch 90, 1070, Brussels, Belgium., Liberale G; Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Rue Meylemeersch 90, 1070, Brussels, Belgium.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2023 Sep; Vol. 49 (9), pp. 106911. Date of Electronic Publication: 2023 Apr 23.
DOI: 10.1016/j.ejso.2023.04.010
Abstrakt: Introduction: Although complete cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) offers a good prognosis in patients with peritoneal metastasis of ovarian cancer (PMOC), recurrences are quite common. These recurrences can be intra-abdominal or systemic in nature. Our objective was to study and illustrate the global recurrence pattern in patients operated for PMOC, shedding light on a previously overlooked lymphatic basin at the level of the epigastric artery, the deep epigastric lymph nodes (DELN) basin.
Patients and Methods: This was a retrospective study including patients with PMOC who underwent surgery with curative-intent, from 2012 until 2018, at our cancer center, and who presented with any type of disease recurrence on follow-up. CT-scans, MRIs and PET-scans were reviewed in order to determine solid organs and lymph nodes (LN) recurrences.
Results: During the study period, 208 patients underwent CRS ± HIPEC, 115 (55.3%) presented with organ or lymphatic recurrence over a median follow-up of 81 months. Sixty percent of these patients had radiologically enlarged LN involvement. The pelvis/pelvic peritoneum was the most common intra-abdominal organ recurrence site (47%), while the retroperitoneal LN was the most common lymphatic recurrence site (73.9%). Previously overlooked DELN were found in 12 patients, with 17.4% implication in lymphatic basin recurrence patterns.
Conclusion: Our study revealed the potential role of the DELN basin, previously overlooked in the systemic dissemination process of PMOC. This study sheds light on a previously unrecognized lymphatic pathway, as an intermediate checkpoint or relay, between the peritoneum, an intra-abdominal organ, and the extra-abdominal compartment.
Competing Interests: Declaration of competing interest Authors declare no conflict of interest.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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