Survival benefits of retroperitoneal lymphadenectomy for optimally-resected advanced ovarian high-grade serous carcinoma: a multi-institutional retrospective study
Year: 2022
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: The survival benefits of retroperitoneal lymphadenectomy (RLNA) for epithelial ovarian cancer (EOC) remain controversial because clinical behaviors differ among subtypes. The purpose of the present study was to clarify whether RLNA increases the survival rate of advanced high-grade serous carcinoma (HGSC). METHODS: This was a retrospective cohort analysis of 3,227 patients with EOC treated between 1986 and 2017 at 14 institutions. Among them, 335 patients with stage IIB-IV HGSC who underwent optimal cytoreduction (residual tumor of <1 cm) were included. Patients were divided into the RLNA group (n=170) and non-RLNA group (n=165). All pathological slides were assessed based on a central pathological review. Oncologic outcomes were compared between the two groups in the original and weighted cohorts adjusted with the inverse probability of treatment weighting. RESULTS: The median observation period was 49.8 (0.5-241.5) months. Overall, 219 (65%) out of 335 patients had recurrence or progression, while 146 (44%) died of the disease. In the original cohort, RLNA was a significant prognostic factor for longer progression-free survival (PFS) (hazard ratio [HR]=0.741; 95% confidence interval [CI]=0.558-0.985) and overall survival (OS) (HR=0.652; 95% CI=0.459-0.927). In the weighted cohort in which all variables were well balanced as standardized differences decreased, RLNA was also a significant prognostic factor for more favorable oncologic outcomes (PFS, adjusted HR=0.742; 95% CI=0.613-0.899) and OS, adjusted HR=0.620; 95% CI=0.488-0.787). CONCLUSION: The present study demonstrated that RLNA for stage III-IV HGSC with no residual tumor after primary debulking surgery contributed to better oncologic outcomes.
Source: Journal of Gynecologic Oncology
Institution: Nagoya University
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Awards: Elucidating and targeting functional structure of peritoneal matrisome for controlling advanced ovarian cancer, Pathophysiology of Peritoneal dissemination via Extracellular Vesicles in p53 Mutant Ovarian Cancer, Interdisciplinary study on the peritoneal metastasis of patients with ovarian cancer based on the adipo-peritoneal crosstalk, Novel heterogeneity analyses for extracellular vesicles in micro volume bio-fluids, Development of intraperitoneal environmental strategies for advanced ovarian cancer focusing on peptid degradomics in ascites, Investigation of cancer extracellular vesicles for their revealing heterogeneity, Elucidating the mechanisms of intracellular communication within the peritoneal cavity inducing the construction of a dormancy-maintaining environment for occult cancer metastasis, Development of Novel Ovarian Cancer Treatment Strategies by Translational Analysis of Extracellular Vesicles, Elucidation of malignancy, peritoneal dissemination and spread mechanism of ovarian cancer by interaction with peritoneal mesothelium., Functional analysis of cancer-associated mesothelial cells aimed at disease control of advanced ovarian cancer and development of peritoneal restoration therapy
OpenAlex ID: W4214856449