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143 Radiologically enlarged cardiophrenic lymph nodes and CA-125 in relation to diaphragmatic carcinomatosis, surgical outcome, and overall survival in advanced ovarian cancer
  1. Alba Plana1,
  2. Robert Talo1,
  3. Nils-Olof Wallengren2,
  4. Sonja Pudaric2,
  5. Hanna Sartor3 and
  6. Mihaela Asp1
  1. 1Department of Obstetrics and Gynecology, Department of Clinical Science Lund, Skåne University Hospital, Lund University, Lund, Sweden
  2. 2Division of Medical Imaging and Physiology, Department of Clinical Science, Skåne University Hospital, Lund, Sweden
  3. 3Diagnostic Radiology, Department of Translational Medicine, Skåne University Hospital, Lund University, Lund, Sweden


Introduction/Background We primarily aimed to determine whether the presence of enlarged cardiophrenic lymph nodes (CPLNs), visualized by computed tomography (CT), and CA-125 can be used to assess diaphragmatic carcinomatosis and residual disease (RD) in advanced ovarian cancer (AOC) patients treated with upfront surgery. The secondary aim was to determine the prognostic role of CT-CPLNs in overall survival (OS).

Methodology A single-centre, retrospective, population-based study was conducted of patients who underwent surgery for AOC from January 1, 2014-December 31, 2018. Suspicious CT-CPLNs were defined as having a short axis ≥ 5 mm. The median survival and rate of survival were calculated with the Kaplan-Meier method using multivariate Cox regression analyses, including comparisons of complete cytoreductive surgery (CCS; defined as the complete removal of all intra-abdominal tumour) versus noncomplete cytoreductive surgery (non-CCS) and analyses related to CT-CPLN status and preoperative CA-125 values.

Results We included 208 patients. CT-CPLNs correlated with both diaphragmatic carcinomatosis (OR 3.59, 95% CI 1.81–7.16, p<0.01) and RD (OR 2.54, 95% CI 1.38–4.6, p=0.003). When CCS was achieved, no differences in survival between patients with suspicious or nonsuspicious CT-CPLNs were found. The relationships between CA-125 ≥ 500 U/ml and diaphragmatic carcinomatosis (OR 3.51, 95% CI 1.86–6.64, p<0.01) and RD (OR 2.41, 95% CI 1.33–4.38, p=0.004) were positive. All data were adjusted for age and ECOG performance status. Survival analyses were also adjusted for RD.

Conclusion Enlarged CPLNs on CT scans and CA-125 levels correlate with diaphragmatic carcinomatosis and RD at the end of the surgery. The strongest prognostic factor for OS remains CCS, regardless of the CT-CPLN status.

Disclosures The authors declare no potential conflict of interest.

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