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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

邮发代号 80-967

2019 Impact Factor: 3.421

Frontiers of Medicine  2014, Vol. 8 Issue (1): 96-100   https://doi.org/10.1007/s11684-014-0316-4
  RESEARCH ARTICLE 本期目录
Clinical significance of para-aortic lymph node dissection and prognosis in ovarian cancer
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.

Key wordsovarian cancer    para-aortic lymph node    pelvic lymph node
收稿日期: 2013-08-02      出版日期: 2014-04-26
Corresponding Author(s): Xing Hui,Email:huixing1969@163.com   
 引用本文:   
. Clinical significance of para-aortic lymph node dissection and prognosis in ovarian cancer[J]. Frontiers of Medicine, 2014, 8(1): 96-100.
Xianxian Li, Hui Xing, Lin Li, Yanli Huang, Min Zhou, Qiong Liu, Xiaomin Qin, Min He. Clinical significance of para-aortic lymph node dissection and prognosis in ovarian cancer. Front Med, 2014, 8(1): 96-100.
 链接本文:  
https://academic.hep.com.cn/fmd/CN/10.1007/s11684-014-0316-4
https://academic.hep.com.cn/fmd/CN/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  
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  
Survival rates(%)P
GroupCases1 Y2 Y3 Y4 Y5 Yvalue
A3094.785.777.963.346.7
B5092.780.169.058.839.20.976
Tab.3  
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  
1 Fotopoulou C, Savvatis K, Steinhagen-Thiessen E, Bahra M, Lichtenegger W, Sehouli J. Primary radical surgery in elderly patients with epithelial ovarian cancer: analysis of surgical outcome and long-term survival. Int J Gynecol Cancer 2010; 20(1): 34-40
doi: 10.1111/IGC.0b013e3181c10c04 pmid:20130501
2 Heintz AP, Odicino F, Maisonneuve P, Quinn MA, Benedet JL, Creasman WT, Ngan HY, Pecorelli S, Beller U. Carcinoma of the ovary. FIGO 6th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2006; 95(S1): S161-S192
doi: 10.1016/S0020-7292(06)60033-7
3 Mujezinovi? F, Takac I. Pelvic lymph node dissection in early ovarian cancer: success of retrieval of lymph nodes by individual lymph node groups in respect to pelvic laterality. Eur J Obstet Gynecol Reprod Biol 2010; 151(2): 208-211
doi: 10.1016/j.ejogrb.2010.04.011 pmid:20457482
4 Pereira A, Pérez-Medina T, Magrina JF, Magtibay PM, Rodríguez-Tapia A, Pérez-Milán F, Ortiz-Quintana L. The impact of pelvic retroperitoneal invasion and distant nodal metastases in epithelial ovarian cancer. Surg Oncol . 2013 Oct 25. [Epub ahead of print]
doi: 10.1016/j.suronc.2013.10.005 pmid:10.1016/j.suronc.2013.10.00524183480" target="blank">
doi: 10.1016/j.suronc.2013.10.00524183480
5 Morice P, Joulie F, Camatte S, Atallah D, Rouzier R, Pautier P, Pomel C, Lhommé C, Duvillard P, Castaigne D. Lymph node involvement in epithelial ovarian cancer: analysis of 276 pelvic and paraaortic lymphadenectomies and surgical implications. J Am Coll Surg 2003; 197(2): 198-205
doi: 10.1016/S1072-7515(03)00234-5 pmid:12892797
6 Powless CA, Aletti GD, Bakkum-Gamez JN, Cliby WA. Risk factors for lymph node metastasis in apparent early-stage epithelial ovarian cancer: implications for surgical staging. Gynecol Oncol 2011; 122(3): 536-540
doi: 10.1016/j.ygyno.2011.05.001 pmid:21636114
7 Karabuk E, Kose MF, Hizli D, Ta?kin S, Karada? B, Turan T, Boran N, Ozfuttu A, Orta? UF. Comparison of advanced stage mucinous epithelial ovarian cancer and serous epithelial ovarian cancer with regard to chemosensitivity and survival outcome: a matched case-control study. J Gynecol Oncol 2013; 24(2): 160-166
doi: 10.3802/jgo.2013.24.2.160 pmid:23653834
8 Cass I, Li AJ, Runowicz CD, Fields AL, Goldberg GL, Leuchter RS, Lagasse LD, Karlan BY. Pattern of lymph node metastases in clinically unilateral stage I invasive epithelial ovarian carcinomas. Gynecol Oncol 2001; 80(1): 56-61
doi: 10.1006/gyno.2000.6027 pmid:11136570
9 Hiura M, Nogawa T, Matsumoto T, Yokoyama T, Shiroyama Y, Wroblewski J. Long-term survival in patients with para-aortic lymph node metastasis with systematic retroperitoneal lymphadenectomy followed by adjuvant chemotherapy in endometrial carcinoma. Int J Gynecol Cancer 2010; 20(6): 1000-1005
doi: 10.1111/IGC.0b013e3181d80aff pmid:20683408
10 Zinzindohoue C, Lujan R, Boulet S, Spirito C, Bobin JY. Pelvic and para-aortic lymphadenectomy in epithelial ovarian cancer. Report of a series of 86 cases. Ann Chir 2000; 125(2): 163-172 (in French)
doi: 10.1016/S0003-3944(00)00233-9 pmid:10998803
11 Polverino G, Parazzini F, Stellato G, Scarfone G, Cipriani S, Bolis G. Survival and prognostic factors of women with advanced ovarian cancer and complete response after a carboplatin-paclitaxel chemotherapy. Gynecol Oncol 2005; 99(2): 343-347
doi: 10.1016/j.ygyno.2005.06.008 pmid:16051334
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