Prognostic role of mesenteric lymph nodes involvement in patients undergoing posterior pelvic exenteration during radical or supra-radical surgery for advanced ovarian cancer
| Autor: | Marcello Ceccaroni, Matteo Riccò, Maurizio Di Serio, Valentina Ceni, Giulio Sozzi, Giovanna Giordano, Roberto Berretta, Federico Marchesi, Lavinia Volpi, Vito Andrea Capozzi, Michela Monica, Mauro Melpignano |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Colorectal cancer Ovariectomy medicine.medical_treatment Carcinoma Ovarian Epithelial 030230 surgery Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Abdomen medicine Humans Mesenteric lymph nodes Neoplasm Invasiveness Radical surgery Aged Retrospective Studies Ovarian Neoplasms business.industry digestive oral and skin physiology Rectum Obstetrics and Gynecology Postoperative complication Cytoreduction Surgical Procedures General Medicine Bowel resection Middle Aged Prognosis medicine.disease Debulking Pelvic Exenteration Posterior Pelvic Exenteration Surgery medicine.anatomical_structure CA-125 Antigen Lymphatic Metastasis 030220 oncology & carcinogenesis Female Lymph Nodes Neoplasm Recurrence Local Ovarian cancer business |
| Zdroj: | Archives of Gynecology and Obstetrics. 297:997-1004 |
| ISSN: | 1432-0711 0932-0067 |
| DOI: | 10.1007/s00404-018-4675-y |
| Popis: | The aim of this retrospective study is to analyze the prognostic role and the practical implication of mesenteric lymph nodes (MLN) involvements in advanced ovarian cancer (AOC). A total of 429 patients with AOC underwent surgery between December 2007 and May 2017. We included in the study 83 patients who had primary (PDS) or interval debulking surgery (IDS) for AOC with bowel resection. Numbers, characteristics and surgical implication of MLN involvement were considered. Eighty-three patients were submitted to bowel resection during cytoreduction for AOC. Sixty-seven patients (80.7%) underwent primary debulking surgery (PDS). Sixteen patients (19.3%) experienced interval debulking surgery (IDS). 43 cases (51.8%) showed MLN involvement. A statistic correlation between positive MLN and pelvic lymph nodes (PLN) (p = 0.084), aortic lymph nodes (ALN) (p = 0.008) and bowel infiltration deeper than serosa (p = 0.043) was found. A longer overall survival (OS) and disease-free survival was observed in case of negative MLN in the first 20 months of follow-up. No statistical differences between positive and negative MLN in terms of operative complication, morbidity, Ca-125, type of surgery (radical vs supra-radical), length and site of bowel resection, residual disease and site of recurrence were observed. An important correlation between positive MLN, ALN and PLN was detected; these results suggest a lymphatic spread of epithelial AOC similar to that of primary bowel cancer. The absence of residual disease after surgery is an independent prognostic factor; to achieve this result should be recommended a radical bowel resection during debulking surgery for AOC with bowel involvement. |
| Databáze: | OpenAIRE |
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