Premium
Effects of pretreatment radiological and pathological lymph node statuses on prognosis in patients with ovarian cancer who underwent interval debulking surgery with lymphadenectomy following neoadjuvant chemotherapy
Author(s) -
Komatsu Hiroaki,
Iida Yuki,
Osaku Daiken,
Shimogai Ruri,
Chikumi Jun,
Sato Shinya,
Oishi Tetsuro,
Harada Tasuku
Publication year - 2021
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14446
Subject(s) - medicine , debulking , lymphadenectomy , surgery , lymph node , ovarian cancer , pathological , chemotherapy , univariate analysis , survival rate , oncology , cancer , radiology , multivariate analysis
Aim To analyze whether radiological and pathological lymph node statuses affected prognosis in patients with epithelial ovarian cancer who underwent neoadjuvant chemotherapy followed by interval debulking surgery. Methods In total, 82 patients undergoing interval debulking surgery, including systematic retroperitoneal lymphadenectomy, were eligible for this study. We retrospectively analyzed the association among radiological diagnosed retroperitoneal lymphadenopathy by computed tomographic scan before (rLN) and after (yrLN) neoadjuvant chemotherapy, pathological lymph node metastasis (pLN) and prognosis. Patient survival distribution was calculated using the Kaplan–Meier method. Results There were 36 rLN+ cases (44%); there were no significant differences between rLN+ and rLN− with respect to progression‐free survival and overall survival. Progression‐free survival and overall survival did not differ between yrLN+ cases and yrLN− cases. Thirty‐nine cases (47.5%) were pLN+, and both progression‐free survival and overall survival were significantly shorter in pLN+ cases than in pLN− cases ( P < 0.001 and P = 0.004, respectively). In univariate analysis, FIGO stage, pLN and surgical completion were prognostic factors for overall survival. Moreover, in multivariate analysis, pLN+ was the independent prognostic factor for progression‐free survival ( P = 0.001, 95% confidence interval: 1.911–15.69), and pLN and surgical completion were the only independent prognostic factors for overall survival ( P = 0.046, P = 0.012). Conclusion Radiological lymph node status may not be a prognostic factor in patients with ovarian cancer who underwent neoadjuvant chemotherapy followed by interval debulking surgery. Pathological lymph node metastasis affects progression‐free survival and overall survival.