Premium
The prognostic impact of the ratio of positive lymph nodes on survival of epithelial ovarian cancer patients
Author(s) -
Mahdi Haider,
Thrall Melissa,
Kumar Sanjeev,
Hanna Rabbie,
Seward Shelly,
Lockhart David,
Morris Robert T.,
Swensen Ron,
Munkarah Adnan R.
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21869
Subject(s) - medicine , stage (stratigraphy) , proportional hazards model , ovarian cancer , lymph node , lymphadenectomy , oncology , survival analysis , hazard ratio , epithelial ovarian cancer , lymph , epidemiology , gastroenterology , surveillance, epidemiology, and end results , cancer , pathology , cancer registry , paleontology , confidence interval , biology
Abstract Background and Objectives To study the prognostic significance of ratio of positive to examined lymph nodes (LNR) on survival of patients with node positive epithelial ovarian cancer (NPEOC). Methods Data were obtained from Surveillance, Epidemiology, and End Results Program (SEER) from 1988 to 2006, and analyzed using Kaplan–Meier survival and Cox regression proportional hazard methods. Patients were divided into: stage IIIC group 1 (no macroscopic peritoneal disease), stage IIIC group 2 (macroscopic peritoneal disease), and stage IV. Results A total of 6,310 women were included. The 5‐year survival for stage IIIC groups 1, 2, and stage IV was 55.4%, 35.5%, and 20.3%, respectively ( P < 0.001). Increasing LNR (<10%, 10–50%, and >50%) was associated with decreased survival from 51.5% to 38.1% to 27.0%, respectively, ( P < 0.001). On multivariate analysis, LNR was an independent prognostic factor for survival after adjusting for extent of peritoneal disease, stage, grade, race, age, extent of lymphadenectomy and absolute number of positive nodes. Conclusions The impact of increasing LNR was strongly related to survival, especially in patients with no macroscopic peritoneal disease. Stratification of this subpopulation of node positive EOC based on nodal burden provides a significant prognostic value that may be considered in future staging and aid in management decisions. J. Surg. Oncol. 2011;103:724–729. © 2011 Wiley‐Liss, Inc.