Introduction/Background To identify prognostic factors of survival and recurrence in advanced ovarian cancer patients with peritoneal carcinomatosis, undergoing cytoreductive surgery and Hyperthermic IntraPEritoneal Chemotherapy (HIPEC). In particular, to identify the rate and possible role of metastatic lymph nodes, according to their anatomic distribution.
Methodology Retrospective analysis of 152 patients with advanced ovarian cancer that underwent complete or near-complete cytoreduction, which included at least one colonic resection and HIPEC. Clinical and histopathological variables were correlated to survival and recurrence. All patients were treated by a single team, with a standard protocol for surgical technique/HIPEC.
Results Mean age of the patients was 58.8 years and complete cytoreductive surgery was possible in 72.4%. The rates of in-hospital mortality and major morbidity were 2.6% and 15.7%, respectively. Only 122 (80.3%) patients were able to complete adjuvant systemic chemotherapy. Rates of metastatic total lymph nodes, para-aortic and pelvic lymph nodes and large bowel lymph nodes were 58.7%, 58.5%, and 51.3%, respectively. The median, 5- and 10-year survival rates were 39 months, 43%, and 36.2%, respectively. The recurrence rate was 35.5%. On univariate analysis, near-complete cytoreduction, high Peritoneal Cancer Index, in-hospital morbidity, and no adjuvant systemic chemotherapy were adverse prognostic factors, both, for survival and recurrence. On multivariate analysis, negative prognostic survival indicators were the advanced age of patients, extensive peritoneal dissemination, low total number of resected lymph nodes and no systemic para-aortic/pelvic lymphadenectomy. Metastatic large bowel lymph nodes and segmental resections of the small intestine were associated with a high risk for recurrence.
Conclusion Retroperitoneal lymph nodes are frequently involved in advanced ovarian cancer. Our data show that extensive lymphadenectomy, including systemic para-aortic/pelvic and large bowel lymphadenectomy, may be important in advanced ovarian cancer surgery, as it may confer to survival improvement and decrease the risk of recurrence.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.