Introduction/Background The therapeutic role of systematic pelvic and para-aortic lymphadenectomy in surgical staging of apparent early-stage epithelial ovarian cancer (aeEOC) is still unclear. Recently, ESGO-ESMO consensus conference established that re-staging lymphadenectomy is not recommended if patients are due to receive adjuvant chemotherapy for high-risk eEOC. The aim of this study was to define the therapeutic role of systematic lymphadenectomy in patients with eEOC, who received complete adjuvant chemotherapy.
Methodology Single-center retrospective cohort study with Institutional Review Board approval, comparing women with aeEOC who underwent no (NL) or inadequate lymphadenectomy (IL) versus patients receiving adequate systematic bilateral pelvic and para-aortic lymphadenectomy (AL) (defined as ≥20 lymph-nodes).
Inclusion criteria: epithelial ovarian carcinoma; no bulky (≥10 mm short axis) pelvic or para-aortic lymph nodes at CT-scan; complete intra-peritoneal surgical staging and adjuvant chemotherapy as follow: i) from 3 to 6 cycles of carboplatin/paclitaxel; ii) 6 cycles of carboplatin only.
Results From January 2006 to December 2016, 570 patients with FIGO stage IA-IIIA1 ovarian cancer were found. Of these 409 were excluded. 161 patients met inclusion criteria. 51 underwent AL, 84 IL and 26 NL. Patients‘ and surgery’s characteristics are showed in table 1. Patients who underwent AL were younger (p=0.011) and had higher rate of severe post-operative complications (p=0.01). Median follow-up was 45 (41–48) months. 5-year progression-free survival was 78.1% and 66.0% HR (95% CI)=1.47(0.74–2.95) (log rank test p=0.268), and overall-survival was 96.3% and 88.7% HR (95% CI)=2.22 (0.64–7.73) (log rank test p=0.194), in IL/NL versus AL, respectively (figure 1).
Conclusion Systematic lymphadenectomy in surgical staging of eEOC does not seem to have a therapeutic value and increases the rate of severe post-operative complications. However, results from an ongoing multicentric study, with larger number of cases, will draw definitive conclusions.
Disclosure Nothing to disclose.
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