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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2014, Vol. 8 Issue (1) : 96-100    https://doi.org/10.1007/s11684-014-0316-4
RESEARCH ARTICLE
Clinical significance of para-aortic lymph node dissection and prognosis in ovarian cancer
Xianxian Li, Hui Xing(), Lin Li, Yanli Huang, Min Zhou, Qiong Liu, Xiaomin Qin, Min He
Department of Obstetrics and Gynecology, Xiangyang Central Hospital, Hospital Affiliated to Hubei University of Arts and Science, Xiangyang 441021, China
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Abstract

Lymph node metastasis has an important effect on prognosis of patients with ovarian cancer. Moreover, the impact of para-aortic lymph node (PAN) removal on patient prognosis is still unclear. In this study, 80 patients were divided into groups A and B. Group A consisted of 30 patients who underwent PAN+ pelvic lymph node (PLN) dissection, whereas group B consisted of 50 patients who only underwent PLN dissection. Analysis of the correlation between PAN clearance and prognosis in epithelial ovarian cancer was conducted. Nineteen cases of lymph node metastasis were found in group A, among whom seven cases were positive for PAN, three cases for PLN, and nine cases for both PAN and PLN. In group B, 13 cases were positive for lymph node metastasis. Our study suggested that the metastatic rate of lymph node is 40.0%. Lymph node metastasis was significantly correlated with FIGO stage, tumor differentiation, and histological type both in groups A and B (P<0.05). In groups A and B, the three-year survival rates were 77.9% and 69.0%, and the five-year survival rates were 46.7% and 39.2%, respectively. However, the difference was not statistically significant (P>0.05). The three-year survival rates of PLN metastasis in groups A and B were 68.5% and 41.4%, and the five-year survival rates were 49.7% and 26.4%, respectively. Furthermore, PLN-positive patients who cleared PAN had significantly higher survival rate (P=0.044). In group A, the three-year survival rates of positive and negative lymph nodes were 43.5% and 72.7%, and the five-year survival rates were 27.2% and 58.5%, respectively. The difference was statistically significant (P=0.048). Cox model analysis of single factor suggested that lymph node status affected the survival rate (P<0.01), which was the death risk factor. Consequently, in ovarian carcinoma cytoreductive surgery, resection of the para-aortic lymph node, which has an important function in clinical treatment and prognosis of patients with ovarian cancer, is necessary.

Keywords ovarian cancer      para-aortic lymph node      pelvic lymph node     
Corresponding Author(s): Xing Hui,Email:huixing1969@163.com   
Issue Date: 26 April 2014
 Cite this article:   
Xianxian Li,Hui Xing,Lin Li, et al. Clinical significance of para-aortic lymph node dissection and prognosis in ovarian cancer[J]. Front Med, 2014, 8(1): 96-100.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-014-0316-4
https://academic.hep.com.cn/fmd/EN/Y2014/V8/I1/96
RelatedNo. ofGroup AGroup B
factorscases+ (%)- (%)P value+ (%)- (%)P value
Age (Year)
&lt;50327(21.88)5(15.63)6(18.75)14(43.75)
≥504812(25.00)6(12.50)0.4667(14.58)23(47.92)0.418
FIGO stage
I-II280(0.00)4(14.20)0(0.00)24(85.71)
III4415(34.09)6(13.64)11(25.00)12(27.27)
IV84(50.00)1(12.50)0.0172(25.00)1(12.50)0.001
Pathological grade
G1151(6.67)4(26.67)0(0.00)10(66.67)
G2223(13.64)4(18.18)3(13.64)12(54.55)
G34315(34.88)3(6.98)0.01510(23.26)15(34.88)0.042
Tumor size
&lt;10 cm5311(20.75)7(13.21)11(20.75)24(45.28)
≥10 cm278(29.63)4(14.81)0.5342(7.41)13(48.15)0.163
Histological type
Serous5018(36.00)7(14.00)10(20.00)15(30.00)
Non-Serous301(3.33)4(13.33)0.0473(10.00)22(73.33)0.025
Serum CA125
&lt;50 IU/ml91(11.11)3(44.44)0(0.00)5(55.56)
50 IU/ml to 500 IU/ml315(16.13)3(9.68)4(12.90)19(61.29)
&gt;500 IU/ml4013(32.50)5(10.00)0.2079(22.50)13(35.00)0.075
Tab.1  Association between lymph node status and clinical-pathological factors in groups A and B
DistributionCasesLeft(%)Right(%)Bilateral(%)
Internal iliac117(36.84)1(5.26)3(15.79)
External iliac41(5.26)1(5.26)2(10.53)
Common iliac82(10.53)3(15.79)3(15.79)
Inguinal72(10.53)3(15.79)2(10.53)
Closed holes82(10.53)3(15.79)3(15.79)
Para-aortic162(10.53)8(42.11)6(31.58)
Tab.2  Distribution of lymph nodes metastasis in group A
Survival rates(%)P
GroupCases1 Y2 Y3 Y4 Y5 Yvalue
A3094.785.777.963.346.7
B5092.780.169.058.839.20.976
Tab.3  Comparison of survival rates between groups A and B
Lymph nodesSurvival rates(%)P
StatusCases1Y2Y3Y4Y5Yvalue
Without LN metastasis
A1195.988.379.275.370.4
B3790.280.273.362.659.50.987
Metastasis to PLN
A1789.685.168.560.249.7
B887.568.641.435.226.40.044
Metastasis to PAN
1693.282.367.650.540.3
In group A
LN (+)1988.763.243.536.127.2
LN (-)1195.285.972.767.358.50.048
Tab.4  Correlation between lymph node status and survival rates in groups A and B
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