Pattern and impact of metastatic cardiophrenic lymph nodes in advanced epithelial ovarian cancer
| Autor: | Philipp Harter, Pier Francesco Alesina, Andreas du Bois, Stephanie Schneider, Jens Albrecht Koch, Sonia Prader, Mareike Bommert, Kai-Uwe Waltering, Alexander Traut, Beyhan Ataseven, Nils Vollmar, Sebastian Heikaus, Florian Heitz |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment Medizin Carcinoma Ovarian Epithelial Complete resection Resection 03 medical and health sciences 0302 clinical medicine medicine Humans Epithelial ovarian cancer Stage (cooking) Neoplasm Staging Ovarian Neoplasms business.industry Obstetrics and Gynecology medicine.disease Debulking 030104 developmental biology Oncology Lymphatic Metastasis 030220 oncology & carcinogenesis Female Lymphadenectomy Lymph Radiology Ovarian cancer business |
| Zdroj: | Gynecologic Oncology. 152:76-81 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2018.11.001 |
| Popis: | Background Cardiophrenic lymph nodes (CPLN) define FIGO stage IVB disease. We evaluate the pattern of CPLN metastases, their prognostic impact and the potential role of CPLN resection in patients with epithelial ovarian cancer (EOC). Methods Analysis of 595 consecutive patients with EOC treated in the period 01/2011–05/2016. CT scans were re-reviewed by two radiologists. Positive CPLN were defined as ≥5 mm in the short-axis diameter. The role of CPLN resection was evaluated in a case-control matched-pair analysis. Results Of 595 patients 458 had FIGO stage IIIB-IV disease. We excluded patients undergoing interval surgery (n = 54), without debulking surgery (n = 32) and without sufficient pre-operative imaging (n = 22), resulting in a study cohort of 350 patients. Of these, 133 (37.9%) had negative CPLN and 217 (62.0%) had radiologically positive CPLN. In patients with postoperative residual tumor, enlarged CPLN had no impact on survival. In patients with complete resection (n = 223), 98 (44.0%) had negative CPLN and a 5-year OS of 69% and a 5-year PFS of 41%; in contrast, in the 125 patients (56.0%) with positive CPLN, 5-year OS was 30% and 5-year PFS was 13%. In 52 patients we resected CPLN. The matched-pair case-control analysis did not demonstrate any significant impact on survival of CPLN resection. Conclusion CPLN metastases are associated with impaired PFS and OS in patients with macroscopically completely resected tumor. Intraabdominal residual tumor has a greater prognostic impact than positive CPLN. The impact of the resection of CPLN remains unclear. |
| Databáze: | OpenAIRE |
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