Introduction/Background Completeness of cytoreduction is the most important prognostic factor in patients with advanced ovarian cancer (OC). Extensive upper abdominal surgery has allowed to increase the rate of complete cytoreduction. The feasibility of resection of celiac lymph nodes (CLN) and porta hepatis disease in these patients has been demonstrated. The aim of our study was to assess the prognostic impact of CLN involvement in patients with primary advanced OC after complete cytoreductive surgery (CRS).
Methodology We designed a retrospective unicentric study. We reviewed data from patients who underwent CLN resection with or without porta hepatis disease resection, within upfront or interval complete CRS in the frontline treatment of advanced epithelial OC between January 2008 and December 2015. Patients were classified in two groups according to CLN status. Univariate and multivariate analyses were conducted. Survival rates were estimated using Kaplan-Meier method.
Results Forty-three patients were included and positive CLN were found in 39.5% of them. The median disease-free survival in the group of patients with positive and negative CLN were 11.3 months and 25.8 months, respectively (figure 1A). The median overall survival in patients with positive was 31.6 months and in the group with negative CLN it was not reached (figure 1B). Table 1 shows the results of univariate analysis. In multivariate analysis, both CLN involvement and high peritoneal cancer index were independently associated with decreased disease-free survival. Relapse within the 6 months after the end of the chemotherapy was significantly associated with CLN involvement, 2/26 (7.7%) in the group with negative CLN vs. 8/17 (47.1%) in the group with positive CLN (p=0.007).
Conclusion CLN involvement and high preoperative tumor burden are independently associated with decreased survival after complete cytoreduction for OC. CLN involvement is a marker of diffuse disease and an independent risk factor for early recurrent disease.
Disclosure Nothing to disclose.
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