Patients with ovarian carcinoma upstaged to Stage III after systematic lymphadenctomy have similar survival to Stage I/II patients and superior survival to other Stage III patients

Onda, Takashi; Yoshikawa, Hideki; Yasugi, Toshiharu; Mishima, Misako; Nakagawa, Shunsuke; Yamada, Minoru; Matsumoto, Koji; Taketani, Yuji

doi:10.1002/(sici)1097-0142(19981015)83:8<1555::aid-cncr10>3.3.co;2-i

Cited by 30 publications

(44 citation statements)

References 2 publications

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“…11,16,17 Mucinous tumors had the lowest rate of lymph node metastasis. 5,7 The absence of positive nodes among 16 patients with mucinous histotype in our series precludes the necessity of lymphadenectomy, especially in disease stage I. 7,10,15,17 Involvement of both pelvic and para-aortic regions was found most frequently.…”

Section: Discussionmentioning

confidence: 60%

“…7,10,15,17 Involvement of both pelvic and para-aortic regions was found most frequently. 5,7,10,11,14 Isolated pelvic or para-aortic regions were reported with various occurrence, but in general, pelvic nodes had a lower incidence of metastasis than paraaortic region, 6,18 especially above the inferior mesenteric artery. 7,14 However, isolated nodal metastases in unilateral as well as in early stage ovarian cancer were predominant in the pelvic region.…”

Section: Discussionmentioning

confidence: 99%

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Frequency and Distribution of Lymph Node Metastases in Epithelial Ovarian Cancer: Significance of Serous Histology

Haller

Mamula

Krašević

et al. 2011

Int J Gynecol Cancer

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Background:The aim of this retrospective study was to evaluate the incidence and distribution of nodal metastases in relation to the serous versus nonserous histological subtypes of epithelial ovarian cancer.Methods:Patients were treated primarily with upfront surgery, including pelvic and para-aortic systematic lymphadenectomy, up to the level of the left renal vein, before any kind of chemotherapy administration. Patients were classified according the tumor histology into 2 groups: serous (including the cases of mixed histology with a serous component) and nonserous group.Results:A total of 173 patients fulfilled the inclusion criteria; 76 and 97 patients had serous and nonserous ovarian carcinoma, respectively. Positive lymph nodes were found in 59.3% (45/76) and 14.4% (14/97) of patients in the serous and nonserous histology groups, respectively. There was no difference in positive node distribution in 3 regions (pelvic and para-aortic regions, below and above the inferior mesenteric artery) between these 2 groups. Early spread including 1 or 2 positive lymph nodes was predominantly found in the para-aortic region in both groups, serous and nonserous, whereas distribution of positive nodes in patients with 3 or more lymph nodes shows equal presence in pelvic and para-aortic regions.Conclusions:Serous ovarian carcinomas are much more prone to metastasize to lymph nodes than nonserous histological types. However, the pattern of lymph node distribution did not differ between these 2 groups and was similar in the pelvic and para-aortic regions.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Frequency and Distribution of Lymph Node Metastases in Epithelial Ovarian Cancer: Significance of Serous Histology

Haller

Mamula

Krašević

et al. 2011

Int J Gynecol Cancer

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“…Some reports showed a positive relationship between node status and survival, 18,22Y24 whereas others showed survival similarity between node positive and negative tumors. 25,26 However, the results in these reports were derived from retrospective analysis with relatively small numbers of patients. A prospective randomized clinical trial to assess the value of systematic lymphadenectomy in comparison with lymph node sampling was conducted by Maggioni et al, 27 enrolling a total of 268 cases.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Complete Surgical Staging Upon Survival in Early-Stage Ovarian Clear Cell Carcinoma

Takano

Sugiyama

Yaegashi

et al. 2009

International Journal of Gynecological Cancer

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Pure-type clear cell carcinoma (CCC) has been recognized as a distinct subtype of ovarian cancer, showing resistance to conventional platinum-based chemotherapy and resulting in poor prognosis. The aim of the study was to evaluate the effects of complete surgical staging procedures for early-stage CCC patients in a retrospective multi-institutional analysis. During the period 1992 to 2002, a total of 199 patients with pT1 M0 CCC were identified. Survival analysis was estimated by Kaplan-Meier methods, and prognostic factors were evaluated using a Cox regression model. Among pT1 M0 tumors, retroperitoneal lymph node status was negative in 125 cases (pN0, 63%), positive in 10 cases (pN1, 5%), and unknown in 64 cases (pNx, 32%). Progression-free survival of pN1 was significantly worse than that of pN0 (P < 0.05), whereas there was no significant difference between pN1 and pNx. There was no significant difference of overall survival (OS) among the 3 groups. Multivariate analysis revealed that peritoneal cytology status was the only independent prognostic factor for progression-free survival (P = 0.04), but completion of surgical staging procedures was not a prognostic factor. There was no significant prognostic factor for OS. Our study implied that complete surgical staging enabled us to distinguish a high-risk group of recurrence in pT1 M0 CCC; however, the procedure could not improve OS. Although the study was a limited retrospective study, the impact of peritoneal cytology status was more important than complete surgical staging procedure in CCC patients. More effective treatment modality was warranted, especially for CCC cases positive for malignant peritoneal cytology.

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“…In addition, the administration of G-CSF and bone marrow transplantation are necessary to counter the neutropenia resulting from these therapies. 5,[20][21][22] When this is not possible, it is desired that the remaining portion be reduced to less than 2 cm in diameter, [20][21][22] or, if at all possible, to less than 1 cm. 4 The CAP therapy employed in this report was conducted with hyperthermia, and thus the commonly accepted standard was slightly modified.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] These treatments have without doubt resulted in a more favorable prognosis of ovarian carcinoma, even in advanced cases. However, because earlystage ovarian cancer is asymptomatic and there are no reliable screening methods, its diagnosis at an early stage is neither easy nor common.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary treatment with and without hyperthermia for ovarian carcinoma

Hayashi

Iida

Iwata

et al. 1999

International Journal of Clinical Oncology

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Background. We administered multidisciplinary treatment for ovarian carcinoma that included cytoreductive surgery and adjuvant chemotherapy with hyperthermia (mainly CDDP, adjuvant hyperthermochemotherapy) for 2 months after surgery. As deemed necessary, a second cytoreductive surgery was performed during the second-look operation. The maintenance chemotherapy consisted of hyperthermochemotherapy. However, the equipment to administer hyperthermia subsequently became inoperative and our multidisciplinary treatment continued without the hyperthermic component. Methods. This unexpected equipment failure enabled us to obtain cumulative survival rates on multidisciplinary treatment with and without hyperthermia. An analysis is hereby reported. Results.(1) Among all cases at stages Ic-IV, and, in particular, those at stages III and IV, the cumulative survival rates were higher among those receiving multidisciplinary treatment with hyperthermia (group A) than those treated without hyperthermia (group B). (2) Those high survival rates as observed in group A with the multidisciplinary treatment with hyperthermia were the result of the high CDDP concentrations in tumor made possible by hyperthermia. The completeness of our surgery was also high. Conclusion.The special characteristics of the multidisciplinary treatment in this report were the combination of hyperthermia and the total CDDP administration of 400 mg 2 months after surgery. Coupled with a high level of completeness of surgery, we believe that we were successful in making fully effective the application of chemotherapy and hyperthermia, thus improving the prognosis.

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Patients with ovarian carcinoma upstaged to Stage III after systematic lymphadenctomy have similar survival to Stage I/II patients and superior survival to other Stage III patients

Cited by 30 publications

References 2 publications

Frequency and Distribution of Lymph Node Metastases in Epithelial Ovarian Cancer: Significance of Serous Histology

Frequency and Distribution of Lymph Node Metastases in Epithelial Ovarian Cancer: Significance of Serous Histology

The Impact of Complete Surgical Staging Upon Survival in Early-Stage Ovarian Clear Cell Carcinoma

Multidisciplinary treatment with and without hyperthermia for ovarian carcinoma

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