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Abstract
Objective To evaluate the impact of lymphadenectomy (LND) on oncological outcomes in patients surgically treated for apparent early-stage epithelial ovarian cancer (aEOC).
Methods Consecutive patients with aEOC who underwent surgery at Del Ponte Hospital, (Varese-Italy) between January 2000 and December 2019 were analyzed. The cases were stratified according with the performance of lymphadenectomy (LND) or not (NO-LND). Demographic, pathologic and surgical-related characteristics were compared. Survivals curves were estimated with Kaplan-Meier methods and predictors of recurrence were investigated.
Results Overall 109 patients were included, 71 and 38 in LND and NO-LND groups, respectively. No differences were found in terms of baseline characteristics. Patients in LND group (vs. NO-LND) were less likely to present with high grade serous histotype (16,22.9% vs.12,44.4%, p<0.001), while mucinous and endometrioid histology represented 4,5.7% vs. 6,22.2% (p<0.001) and 36,51.4% vs. 0,0% (p<0.001), respectively. The G3 grade was more represented in LND group (40,36.7% vs. 22,20.2%, p<0.001). No differences in terms of FIGO stage (p=0.42), rate of minimally-invasive approach (63,88.7% vs. 32,84.2%, p=0.55), DFS (log-rank=0.79) and OS (log-rank=0.8) were found. With a median follow-up of 63.76 months, 13 patients (11.9%) recurred. LND was not found to be protective for relapse (p=0.77). However, among LND patients, the presence of lymph node metastasis (6/71,8.4%) was significantly associated with recurrence (p= 0.01).
Conclusion The execution of systematic lymphadenectomy for aEOC staging did not influence survival outcomes. The presence of lymph node metastasis remained the main adverse prognostic factor associated with recurrence.