Prognostic significance of lymphadenectomy and prevalence of lymph node metastasis in clinically-apparent stage I endometrioid and mucinous ovarian...
Abstract
OBJECTIVE:
The
aim of the present study was to investigate the prevalence of lymph
node (LN) metastasis in women with
apparent stage I ovarian carcinoma of
endometrioid or mucinous histology and to examine the prognostic
significance of LN sampling/dissection (LND) on patient survival.
METHODS:
The
National Cancer Institute's Surveillance, Epidemiology, and End Results
database was accessed and a cohort of surgically-staged women,
diagnosed between 1988 and 2013, with apparent stage I ovarian carcinoma
of mucinous or endometrioid histology was selected. Information derived
from the histopathology report was employed
to determine whether LND
was performed and the status of harvested LNs. Five-year cancer-specific
survival (CSS) rate was calculated following generation of Kaplan-Meier
curves. Comparisons were made using the log-rank test. Cox proportional
hazard models were constructed to evaluate the effect of LND on
survival.
RESULTS:
A
total of 3354 and 2855 women with endometrioid and mucinous tumors who
met the inclusion criteria were identified. LND was performed in 2307
(
68.8%) and 1602 (56.1%) of them (p<0.001), respectively. The rate of
histopathologically confirmed LN metastasis was 2.1% and 1.7%,
respectively. By multivariate analysis LND was associated with superior
cancer-specific mortality
only for women with endometrioid carcinoma.
CONCLUSIONS:
Lymph
node involvement in women with mucinous and endometrioid ovarian
carcinoma grossly confined to the ovary is infrequent. LND is associated
with a survival advantage for those with endometrioid carcinoma.
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