Survival outcomes of ovarian cancer patients treated with secondary cytoreductive surgery for isolated lymph node recurrence: A systematic review of the literature

Pergialiotis, Vasilios; Androutsou, Anastasia; Papoutsi, Eleni; Bellos, Ioannis; Thomakos, Nikolaos; Haidopoulos, Dimitrios; Rodolakis, Alexandros

doi:10.1016/j.ijsu.2019.07.026

Cited by 11 publications

(5 citation statements)

References 30 publications

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“…ILNR is actually considered as a rare entity in the context of EOC since it affects only 1–5% of relapsed EOC [ 16 , 17 ]. These ILNR has been described as a unique clinical disease entity, moreover, several studies underline a better prognosis in terms of PFS and OS compared to peritoneal or parenchymal forms of recurrence [ 20 , 23 , 24 , 25 , 26 ]. Furthermore, the idea that the lymph-node metastases in ovarian cancers are more chemoresistance has already been proposed by Morice et al in an analysis of 105 patients [ 27 ] and confirmed by several studies [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…These ILNR has been described as a unique clinical disease entity, moreover, several studies underline a better prognosis in terms of PFS and OS compared to peritoneal or parenchymal forms of recurrence [ 20 , 23 , 24 , 25 , 26 ]. Furthermore, the idea that the lymph-node metastases in ovarian cancers are more chemoresistance has already been proposed by Morice et al in an analysis of 105 patients [ 27 ] and confirmed by several studies [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. The lower chemosensitivity of ILNRs can be justified by a lower percentage of cells in S-phase [ 18 ] and a greater CD3 + and CD8 + cell infiltration compared to extranodal relapse [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Tertiary Cytoreduction for Isolated Lymphnode Recurrence (ILNR) Ovarian Cancer in a BRCA2 Mutated Patient: Our Experience and Prevalence of BRCA 1 or 2 Genes Mutational Status in ILNR

et al. 2023

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We report the case of a tertiary cytoreductive surgery for isolated lymph-node recurrence (ILNR) in a 54-years old Brest cancer 2 (BRCA 2) mutated patients, with a personal history of ovarian cancer previously treated elsewhere. She was admitted to our department for a suspected isolated lymph-nodal pelvic recurrence. A positron emission tomography acquisition with contrast enhanced computed tomography (PET-CT) scan revealed an increased node at the level of the right external iliac (SUV 6.9) in correspondence with the obturator nerve, which was confirmed by transvaginal ultrasound. Since the recurrence was in a single site and the patient had previously undergone three lines of chemotherapy and maintenance with Poly(ADP-ribose) polymerase (PARP) inhibitors, we decided to perform tertiary cytoreductive surgery by minimally invasive laparoscopic approach. After gradual and careful isolation of the obturator nerve, lumbo-sacral trunk and venous vessels afferent to the external and internal iliac vein, the suspected node has been removed. No intra- and postoperative complications occurred. The patient was discharged three days after procedure. We decided to quarterly follow-up; actually, after 16 months no recurrence was detected. Several studies have reported ILNR as a unique clinical disease with low growth rate and less chemosensitivity; this can lead to considered ILNR more susceptible to take advantage of surgical treatment, even in case of second or third recurrence. The BRCA mutational status seems to play a role in the decision-making process in the approach to patients with platinum sensitive relapse of ovarian cancer or in specific isolated forms of recurrence such as the hepatic one. However, data on frequency and prognostic impact of BRCA gene mutation in ILNR are very limited. In this article we investigated the role of BRCA 1 or 2 mutational status in this rare pattern of recurrence according to more recent advances in literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tertiary Cytoreduction for Isolated Lymphnode Recurrence (ILNR) Ovarian Cancer in a BRCA2 Mutated Patient: Our Experience and Prevalence of BRCA 1 or 2 Genes Mutational Status in ILNR

et al. 2023

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“…26 Finally, a current review of the literature including 437 patients demonstrated that a combination of secondary debulking surgery plus adjuvant chemotherapy optimize the survival rate. 27…”

Section: Discussionmentioning

confidence: 99%

Solitary lymph-nodal para-aortic recurrence in a patient with High Grade Serous Ovarian Cancer

Fanaki,

Perros,

Pergialiotis

et al. 2023

HJOG

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Ovarian cancer is the second most common cause of gynecologic cancer death. The most common histologic category of epithelial ovarian cancer is High Grade Serous Ovarian Cancer (HGSOC). The initial management usually involves appropriate staging and debulking surgery. Otherwise, patients with unresectable disease receive neoadjuvant chemotherapy, and then undergo Interval Debulking Surgery (IDS). However, even cases with complete clinical response often experience a recurrence. While the primary debulking surgery is the standard of treatment, the role of secondary debulking surgery for recurrent ovarian cancer is still debatable. The most common sites of recurrences are pelvis and abdomen, whereas recurrence confined solely to lymph node is a rare event. Secondary cytoreductive surgery (SCS) for recurrent ovarian cancer presenting as isolated lymph node metastases has been associated with favorable long-term survival, although the resection of aortic metastatic lymph nodes could be related to severe intraoperative complications. In this article, we report a case of a 72-year-old patient with an isolated lymph-nodal para-aortic recurrence with a history of primary debulking surgery for high grade serous ovarian cancer FIGO stage IV, four years before, followed by received adjuvant chemotherapy, and maintenance therapy. The patient presented with a lymph node relapse down the ileocolic artery and submitted to radical resection of the metastatic lymph nodes.

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“…Lymph node recurrence accounts for 12% to 37% of OC relapses [61][62][63][64][65][66][67][68][69], and it is considered more suitable for selected cases to take advantage of surgical rather than medical treatment, because of the low growth rate, relatively lower chemosensitivity, and more indolent behavior compared to parenchymal and peritoneal disease [23].…”

Section: The Minimally-invasive Approachmentioning

confidence: 99%

Minimally-Invasive Secondary Cytoreduction in Recurrent Ovarian Cancer

Certelli,

Russo,

Palmieri

et al. 2023

Cancers

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The role of secondary cytoreductive surgery (SCS) in the treatment of recurrent ovarian cancer (ROC) has been widely increased in recent years, especially in trying to improve the quality of life of these patients by utilising a minimally-invasive (MI) approach. However, surgery in previously-treated patients may be challenging, and patient selection and surgical planning are crucial. Unfortunately, at the moment, validated criteria to select patients for MI-SCS are not reported, and no predictors of its feasibility are currently available, probably due to the vast heterogeneity of recurrence patterns. The aim of this narrative review is to describe the role of secondary cytoreductive surgery and, in particular, minimally-invasive procedures, in ROC, analyzing patient selection, outcomes, criticisms, and future perspectives.

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Survival outcomes of ovarian cancer patients treated with secondary cytoreductive surgery for isolated lymph node recurrence: A systematic review of the literature

Cited by 11 publications

References 30 publications

Tertiary Cytoreduction for Isolated Lymphnode Recurrence (ILNR) Ovarian Cancer in a BRCA2 Mutated Patient: Our Experience and Prevalence of BRCA 1 or 2 Genes Mutational Status in ILNR

Tertiary Cytoreduction for Isolated Lymphnode Recurrence (ILNR) Ovarian Cancer in a BRCA2 Mutated Patient: Our Experience and Prevalence of BRCA 1 or 2 Genes Mutational Status in ILNR

Solitary lymph-nodal para-aortic recurrence in a patient with High Grade Serous Ovarian Cancer

Minimally-Invasive Secondary Cytoreduction in Recurrent Ovarian Cancer

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