Prognostic significance of supradiaphragmatic lymph nodes at initial presentation in patients with stage III high-grade serous ovarian cancer

McIntosh, Laura J.; O’Neill, Ailbhe C.; Bhanusupriya, S; Matalon, Shanna A.; Abbeele, Annick D. Van den; Ramaiya, Nikhil H.; Shinagare, Atul B.

doi:10.1007/s00261-017-1158-8

Cited by 13 publications

(13 citation statements)

References 16 publications

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“…Thirteen articles described retrospective cohort studies [ 9 , 11 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ], one was a case report [ 34 ], and one a case series [ 35 ]. The studies spanned the period from 1997 to 2020.…”

Section: Resultsmentioning

confidence: 99%

“…Despite this finding, only a slightly higher proportion of perioperative complications was found for the CPLN adenopathy group (26% vs. 23%). Eight studies provided survival outcomes [ 9 , 11 , 24 , 25 , 26 , 29 , 32 , 33 ]. The pooled median PFS time was 14.6 months (95% CI 4.9–24.4) vs. 27.8 months (95% CI 3.2–52.5) in patients with and without CPLN adenopathy, respectively.…”

Section: Resultsmentioning

confidence: 99%

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Survival in Advanced-Stage Epithelial Ovarian Cancer Patients with Cardiophrenic Lymphadenopathy Who Underwent Cytoreductive Surgery: A Systematic Review and Meta-Analysis

Kengsakul

Boer

Bijleveld

et al. 2021

Cancers

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Purpose: To evaluate the clinical outcomes of enlarged cardiophrenic lymph node (CPLN) in advanced-stage epithelial ovarian cancer (AEOC) patients who underwent cytoreductive surgery. Methods: The Embase, Medline, Web of Science, Cochrane Library, and Google Scholar databases were searched for articles from the database inception to June 2021. Meta-analysis was conducted to determine the prognostic impact of surgical outcome, postoperative complication, and survival using random-effects models. Results: A total of 15 studies involving 727 patients with CPLN adenopathy and 981 patients without CPLN adenopathy were included. The mean size of preoperative CPLN was 9.1± 3.75 mm. Overall, 82 percent of the resected CPLN were histologically confirmed pathologic nodes. Surgical outcomes and perioperative complications did not differ between both groups. The median OS time was 42.7 months (95% CI 10.8–74.6) versus 47.3 months (95% CI 23.2–71.2), in patients with and without CPLN adenopathy, respectively. At 5 years, patients with CPLN adenopathy had a significantly increased risk of disease recurrence (HR 2.14, 95% CI 1.82–2.52, p < 0.001) and dying from the disease (HR 1.74, 95% CI 1.06–2.86, p = 0.029), compared with those without CPLN adenopathy. CPLN adenopathy was significantly associated with ascites (OR 3.30, 95% CI 1.90–5.72, p < 0.001), pleural metastasis (OR 2.58, 95% CI 1.37–4.82, p = 0.003), abdominal adenopathy (OR 2.30, 95% CI 1.53–3.46, p < 0.001) and extra-abdominal metastasis (OR 2.30, 95% CI 1.61–6.67, p = 0.001). Conclusions: Enlarged CPLN in preoperative imaging is highly associated with metastatic involvement. Patients with CPLN adenopathy had a lower survival rate, compared with patients without CPLN adenopathy. Further randomized controlled trials should be conducted to definitively demonstrate whether CPLN resection at the time of cytoreductive surgery is beneficial.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Survival in Advanced-Stage Epithelial Ovarian Cancer Patients with Cardiophrenic Lymphadenopathy Who Underwent Cytoreductive Surgery: A Systematic Review and Meta-Analysis

Kengsakul

Boer

Bijleveld

et al. 2021

Cancers

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“…However, Kurtin et al (29) reported that lymph node involvement was not associated with an adverse outcome in patients with pulmonary MALT lymphoma. The prognostic role of regional LAP in several malignancies has been considered in previous studies (30,31) and reviews (32). Cahoon et al (32) indicated that understaging of internal thoracic LAP in patients with breast cancer significantly impacted patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

The characteristic computed tomography findings of pulmonary B-cell non-Hodgkin’s lymphoma and their role in predicting patient survival

Wang¹,

Pan²,

Zhu³

et al. 2021

Quant Imaging Med Surg

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Background: To assess the value of characteristic computed tomography (CT) findings in predicting the survival of patients with pulmonary B-cell non-Hodgkin's lymphoma (NHL).Methods: Eighty-four patients who were histopathologically confirmed with pulmonary B-cell NHL between 2004 and 2018 were retrospectively enrolled. All patients underwent chest CT scan at the time of initial diagnosis in our hospital. Characteristic CT findings and clinicopathological features of the patients were analyzed, and Cox regression models were used to determine the relationship of CT findings with overall survival (OS) and progression-free survival (PFS).Results: Air bronchogram occurred more frequently in patients with early-stage disease, primary pulmonary lymphoma (PPL) and the indolent histological type of lymphoma than in patients with advancedstage disease, secondary pulmonary lymphoma (SPL), and the aggressive histological type (all P<0.05). The halo sign was observed most in the SPL group (19/48, 40%; P=0.004), while the presence of cross-lobe sign was higher in patients with PPL (13/36, 36%; P=0.010). Pleural involvement and hilar/mediastinal lymphadenopathy were observed more in patients with SPL and the aggressive histological type (33/48 and 27/48; 31/46 and 26/46, respectively; all P<0.05). Survival analyses showed that the number of lung lesions, cross-lobe sign, and pleural involvement were independent prognostic factors for PFS, while the halo sign and pleural involvement were significantly correlated with OS (all P<0.05). More aggressive, advanced-stage cases and male patients showed worse outcomes. Conclusions:The halo sign and pleural involvement are independent prognostic factors for OS, while the number of lung lesions, cross-lobe sign, and pleural involvement are correlated with PFS.

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“…Celiac lymph node involvement is accompanied with higher rates of large bowel resection and higher incidence of metastasis to small bowel mesentery (44). Lymph node involvement in general does not seem to favorite primary cytoreductive surgery, while peritoneal carcinomatosis increases the rates of cytoreductive failure and surgical complications, if upfront debulking surgery is decided (10,45,46).…”

Section: Peritoneal Carcinomatosismentioning

confidence: 99%

“…Video-assisted thoracoscopy (VATS) was suggested as optimal imaging technique in patients with pleural involvement, in order to assess the stage of the disease, whereas real-time ultrasound elastography was able to evaluate chemotherapy response but the application of the technique is quite limited (3,24). Furthermore, diffusion weighted MRI (DW-MRI) offers an estimated superior predictive value for cytoreductive outcome in approximately 90% of the cases, providing essential information on serosal intestinal, mesenteric vascular and distant site involvement (3,24,46). Last but not least, sonography has been evolved over the years, and although its use is limited, adequate pre-operative assessment of the extent of the disease can be achieved.…”

Section: Radiographic and Nuclear Imagingmentioning

confidence: 99%

Upfront debulking surgery for high-grade serous ovarian carcinoma: current evidence

Tsonis¹,

Gkrozou²,

Vlachos³

et al. 2020

Ann Transl Med

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High-grade serous ovarian carcinoma (HGSOC) is a leading cause of mortality among women worldwide. Currently, there is no clear consensus over the regime these patients should receive. The main two options are upfront debulking surgery with adjuvant chemotherapy or neoadjuvant chemotherapy followed by interval debulking surgery (IDS). The former approach is proposed to be accompanied by lower chemoresistance rates but could lead to severe surgical comorbidities and lower quality of life (QoL). Optimizing patient's selection for upfront debulking surgery might offer higher progression-free and overall survival rates. Further studies need to be conducted in order to elucidate the predictive factors, which are favorable for patients undergoing upfront debulking surgery in cases of high-grade serous ovarian cancer.

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Prognostic significance of supradiaphragmatic lymph nodes at initial presentation in patients with stage III high-grade serous ovarian cancer

Abstract: In patients with stage III HGSC, supradiaphragmatic lymphadenopathy is associated with shorter PFS and OS. Further studies would help determine its implications on staging, decision regarding neoadjuvant therapy, and surgical technique.

Cited by 13 publications

References 16 publications

Survival in Advanced-Stage Epithelial Ovarian Cancer Patients with Cardiophrenic Lymphadenopathy Who Underwent Cytoreductive Surgery: A Systematic Review and Meta-Analysis

Survival in Advanced-Stage Epithelial Ovarian Cancer Patients with Cardiophrenic Lymphadenopathy Who Underwent Cytoreductive Surgery: A Systematic Review and Meta-Analysis

The characteristic computed tomography findings of pulmonary B-cell non-Hodgkin’s lymphoma and their role in predicting patient survival

Upfront debulking surgery for high-grade serous ovarian carcinoma: current evidence

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