The impact of systematic para‐aortic and pelvic lymphadenectomy on survival in patients with optimally debulked ovarian cancer

Abe, Akiko; Furumoto, Hiroyuki; Irahara, Minoru; Ino, Hiroyasu; Kamada, Masao; Naka, Osamu; Sasaki, Masaru; Kagawa, T.; Okitsu, Osamu; Kushiki, N.

doi:10.1111/j.1447-0756.2010.01274.x

Cited by 36 publications

(30 citation statements)

References 19 publications

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“…Since Wang et al (20) compared the OS of patients with residual tumor >2 cm and ≤2 cm, respectively, and Abe et al (25) compared the OS of Stages I-II and III-IV separately, the sets of data increased to 16. The average RR was 1.08 (P = 0.001, 95%CI: 1.03-1.13).…”

Section: Comparisons Of Survival Rates and Heterogeneitymentioning

confidence: 99%

“…These articles, including 1783 cases and 1705 controls, were published between 1994 and 2013 and consisted of 11 observational studies (16)(17)(18)(19)(20)(23)(24)(25)(27)(28)(29) and three RCTs (21)(22)26). Among the included studies, SL was defined as follows: (i) either pelvic or paraaortic lymphadenectomy or both (16)(17)(19)(20)21,(23)(24)(25)(26)(27)(28)(29); (ii) >20 resected pelvic and para-aortic lymph nodes (18,22).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Saygili et al (15): had no conflict of interest statement; without long enough follow-up time; high rate of defaulters. The remaining 11 observational studies whose scores ranged from 7 to 9 with a median score of 8 (16)(17)(18)(19)(20)(23)(24)(25)(27)(28)(29) and three RCTs (21-22,26) with scores from 4 to 5 were finally included in our analyses. Figure 1 shows an overview of the process of selection.…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

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Systematic lymphadenectomy in the treatment of epithelial ovarian cancer: a meta-analysis of multiple epidemiology studies

Gao

Yang

Zhang

2014

Japanese Journal of Clinical Oncology

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Objective: To evaluate the role of systematic lymphadenectomy in epithelial ovarian cancer by comparing 5-year overall survival rates between systematic and unsystematic lymphadenectomies. Methods: A literature search of the Pubmed, Embase and Cochrane Library databases was performed up to 2014. Two authors independently determined the eligibility of the articles and extracted the available data. The role of systematic lymphadenectomy in epithelial ovarian cancer was analyzed by combining all qualified individual studies using a fixed-effect model. Then, subgroup analysis was performed by dividing articles according to type, cancer stage and residual tumor. Finally, heterogeneity and publication bias in all enrolled studies were assessed using Higgins I 2 statistics and funnel plots, respectively.Results: Fourteen relevant studies including 3488 subjects were included in the analysis. The value of pooled relative ratios of all qualified studies revealed that the 5-year overall survival rate in the lymphadenectomy group was higher than that in the unsystematic lymphadenectomy group (relative ratio = 1.08; P = 0.001), which was duplicated in the subgroup analysis of observational studies (relative ratio = 1.07; P = 0.002) and advanced stage (relative ratio = 1.21; P = 0.012) epithelial ovarian cancer. No significant differences were observed in randomized controlled trials (relative ratio = 1.01; P = 0.858), early stage epithelial ovarian cancer (relative ratio = 1.06; P = 0.064) or patients with residual tumor ≤2 cm (relative ratio = 1.05; P = 0.125). The heterogeneity and publication bias in the enrolled studies were within acceptable thresholds. Conclusions: Lymphadenectomy can improve the 5-year overall survival rate in advanced stage epithelial ovarian cancer but not in early stage epithelial ovarian cancer or in patients with residual tumor ≤2 cm.

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Section: Comparisons Of Survival Rates and Heterogeneitymentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

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Systematic lymphadenectomy in the treatment of epithelial ovarian cancer: a meta-analysis of multiple epidemiology studies

Gao

Yang

Zhang

2014

Japanese Journal of Clinical Oncology

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“…Abe et al retrospectively evaluated the contribution of systematic lymphadenectomy on survival in 118, they underlined that systematic lymphadenectomy had improved disease-free, and overall survival in patients with disease confined in pelvis, however in cases with advanced stage who had had optimal debulking, systematic lympadenectomy had not influenced disease-free, and overall survivals. Although systematic lympadenectomy is beneficial for patients with clear cell carcinoma, in advanced stage patients who had had optimal debulking, systematic lympadenectomy did not further improve overall survival or disease-free survival in these patients (Abe et al, 2010). In a study conducted by Panici et al with 419 stage III, and IV patients who had undergone systematic lympadenectomy or only bulky lymph node dissection, in patients with advanced stage optimal debulking, systematic lympadenectomy had not changed overall survival, but improved disease-free survival when compared with bulky node excision (Panici et al, 2005).…”

Section: Discussionmentioning

confidence: 86%

Impact of Prognostic Factors on Survival Rates in Patients with Ovarian Carcinoma

Arikan¹,

Kasap²,

Yetimalar³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Complete cytoreduction (R=0 mm), compared with R>0 mm -≤1 cm, exerts a significantly better prognostic effect on PFS and OS in advanced ovarian cancer (6)(7)(8). The relevance of lymphadenectomy in the primary surgical management of ovarian cancer remains unclear (9,10) and is currently investigated in the prospective LION study (AGO-Ovar).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and distribution pattern of nodal metastases in advanced ovarian cancer

Bachmann

Bachmann²,

Kraemer

et al. 2016

Molecular and Clinical Oncology

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Abstract. The objective of this study was to examine the relevance of pelvic and para-aortic lymph node involvement and the tumour characteristics affecting nodal metastases and survival in primary advanced ovarian cancer. A total of 130 consecutive patients were retrospectively investigated. All the patients received stage-related surgery with pelvic and para-aortic lymphadenectomy. The median follow-up was 53.5 months. The clinicopathological parameters and distribution pattern of nodal metastases were evaluated. Lymph node metastases were detectable in 74.62% of the cases. Overall, both pelvic and para-aortic nodes were affected in 35.9% of the patients, whereas 13.3% had metastases only in the pelvic and 13.3% only in the para-aortic lymph nodes. Histological grade 1/2 and 3, serous and endometrioid histology were independent predictors of nodal metastasis. Serous and endometrioid cancers have shown a predilection for metastasis to the pelvic lymph nodes alone, both to the pelvic and the para-aortic nodes, or the para-aortic nodes alone. Overall survival was significantly positively affected by serous histology with positive nodes (P=0.043). It is crucial to investigate the risk factors and metastatic patterns of such patients in a multicenter analysis to evaluate individual subgroups. Prospective studies are required to investigate the prognostic effect of lymphadenectomy in advanced ovarian cancer and its association with histology and distribution pattern of nodal metastasis.

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The impact of systematic para‐aortic and pelvic lymphadenectomy on survival in patients with optimally debulked ovarian cancer

Cited by 36 publications

References 19 publications

Systematic lymphadenectomy in the treatment of epithelial ovarian cancer: a meta-analysis of multiple epidemiology studies

Systematic lymphadenectomy in the treatment of epithelial ovarian cancer: a meta-analysis of multiple epidemiology studies

Impact of Prognostic Factors on Survival Rates in Patients with Ovarian Carcinoma

Prevalence and distribution pattern of nodal metastases in advanced ovarian cancer

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