Incidence of para-aortic and pelvic lymph node metastases in epithelial carcinoma of the ovary

Chen, Sidney S.; Lee, Louise

doi:10.1016/0090-8258(83)90013-6

Cited by 132 publications

(37 citation statements)

References 6 publications

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“…In early stage ovarian cancer, positive nodes can be found in nine to 25% of patients (Baiocchi et al, 1998). Such variabilility is due to the relatively small size of patient series and the heterogeneity of techiques used to detect and remove retroperitoneal nodes which span from simple sampling (Chen and Lee, 1983;Lanza et al, 1988;Carnino et al, 1997) to systematic lymphadenectomy (Di Re et al, 1989;Burghadt et al, 1991;Benedetti Panici et al, 1993;Carnino et al, 1997;Baiocchi et al, 1998). Our findings are in keeping with these data but represent the first direct comparison of the two surgical approaches to retroperitoneal nodes and are not hampered by the methodologic constrains of retrospective analyses.…”

Section: Discussionsupporting

confidence: 69%

Randomised study of systematic lymphadenectomy in patients with epithelial ovarian cancer macroscopically confined to the pelvis

et al. 2006

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No randomised trials have addressed the value of systematic aortic and pelvic lymphadenectomy (SL) in ovarian cancer macroscopically confined to the pelvis. This study was conducted to investigate the role of SL compared with lymph nodes sampling (CONTROL) in the management of early stage ovarian cancer. A total of 268 eligible patients with macroscopically intrapelvic ovarian carcinoma were randomised to SL (N ¼ 138) or CONTROL (N ¼ 130). The primary objective was to compare the proportion of patients with retroperitoneal nodal involvement between the two groups. Median operating time was longer and more patients required blood transfusions in the SL arm than the CONTROL arm (240 vs 150 min, Po0.001, and 36 vs 22%, P ¼ 0.012, respectively). More patients in the SL group had positive nodes at histologic examination than patients on CONTROL (9 vs 22%, P ¼ 0.007). Postoperative chemotherapy was delivered in 66% and 51% of patients with negative nodes on CONTROL and SL, respectively (P ¼ 0.03). At a median follow-up of 87.8 months, the adjusted risks for progression (hazard ratio [HR] ¼ 0.72, 95%CI ¼ 0.46 -1.21, P ¼ 0.16) and death (HR ¼ 0.85, 95%CI ¼ 0.49 -1.47, P ¼ 0.56) were lower, but not statistically significant, in the SL than the CONTROL arm. Five-year progression-free survival was 71.3 and 78.3% (difference ¼ 7.0%, 95% CI ¼ -3.4 -14.3%) and 5-year overall survival was 81.3 and 84.2% (difference ¼ 2.9%, 95% CI ¼ À7.0 -9.2%) respectively for CONTROL and SL. SL detects a higher proportion of patients with metastatic lymph nodes. This trial may have lacked power to exclude clinically important effects of SL on progression free and overall survival.

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Section: Discussionsupporting

confidence: 69%

Randomised study of systematic lymphadenectomy in patients with epithelial ovarian cancer macroscopically confined to the pelvis

et al. 2006

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“…[8][9][10][11] Cass and colleagues, for example, noted that 14 of 96 women (15%) with apparent Stage I epithelial ovarian cancer at the time of surgery had occult lymph nodal metastases. 11 Therefore, in order to preserve fertility while guaranteeing patient survival, a complete staging operation should be performed.…”

Section: Discussionmentioning

confidence: 99%

Fertility preservation in patients with early epithelial ovarian cancer

et al. 2009

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Objective: To assess the role of fertility preservation in the treatment of patients with early epithelial ovarian cancer (EOC). Methods: We retrospectively analyzed the medical records of 21 patients with early EOC from January 1995 to December 2006. All eligible patients with a strong desire to preserve fertility were younger than 35 years and underwent fertility-sparing surgery with or without adjuvant chemotherapy. Results: Twenty-one eligible patients with a median age of 26.7 years (range, 20 to 33 years) were identified, and the mean follow-up period was 43 months (range, 5 to 86 months). Only one patient with stage IC recurred 34 months after the first operation. A total of five patients were able to become pregnant at least once after the first fertility preserving treatment, with or without adjuvant chemotherapy. All five patients succeeded in full-term vaginal delivery with healthy infants. No patients died of their disease. Conclusion: Fertility preserving treatment in patients with early EOC can be considered as a proper treatment strategy in patients with early EOC, who have the strong desire for fertility preservation.

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“…Although systemic lymphadenectomy is part of the staging procedure in EOC [30][31][32][33][34], two large RCTs in AOC failed to show a significantsurvivaladvantageofsystemiclymphadenectomy [33,34]. However, both trials showed a trend toward a longer progressionfree interval.…”

Section: Optimal Debulking Surgery Milestonesmentioning

confidence: 99%

Advanced Ovarian Cancer: Primary or Interval Debulking? Five Categories of Patients in View of the Results of Randomized Trials and Tumor Biology: Primary Debulking Surgery and Interval Debulking Surgery for Advanced Ovarian Cancer

et al. 2016

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Background. Standard treatment of stage III and IV advanced ovarian cancer (AOC) consists of primary debulking surgery (PDS) followed by chemotherapy. Since the publication of the European OrganisationforResearchandTreatmentofCancer/NationalCancer Institute of Canada trial, clinical practice has changed and many AOC patients are now treated with neoadjuvant chemotherapy (NACT) followedbyintervaldebulkingsurgery(IDS).Thebestoptionremains unclear. Ovarian cancer is a heterogenic disease. Should we use the diversityinbiologyofthetumorandpatternsoftumorlocalizationto better stratify patients between both approaches? Methods. This analysis was based on results of five phase III randomized controlled trials on PDS and IDS in AOC patients, three Cochrane reviews, and four meta-analyses.

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Incidence of para-aortic and pelvic lymph node metastases in epithelial carcinoma of the ovary

Cited by 132 publications

References 6 publications

Randomised study of systematic lymphadenectomy in patients with epithelial ovarian cancer macroscopically confined to the pelvis

Randomised study of systematic lymphadenectomy in patients with epithelial ovarian cancer macroscopically confined to the pelvis

Fertility preservation in patients with early epithelial ovarian cancer

Advanced Ovarian Cancer: Primary or Interval Debulking? Five Categories of Patients in View of the Results of Randomized Trials and Tumor Biology: Primary Debulking Surgery and Interval Debulking Surgery for Advanced Ovarian Cancer

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