6533b851fe1ef96bd12a905e

RESEARCH PRODUCT

Mesenteric Lymph Node Involvement in Advanced Ovarian Cancer Patients Undergoing Rectosigmoid Resection: Prognostic Role and Clinical Considerations

Giovanni ScambiaValerio PapaFrancesca CiccaroneCamilla NeroSergio AlfieriAlessandro Pasquale MargaritiValerio GallottaGabriella FerrandinaGabriella FerrandinaAnna FagottiFrancesco LeggeFrancesco FanfaniVito ChianteraSalvatore Gueli Alletti

subject

OncologySettore MED/18 - CHIRURGIA GENERALEGastroenterologyClear CellSurgical oncology80 and overMucinousMesenteryCystadenocarcinomaLymph nodeAged 80 and overOvarian NeoplasmsMedicine (all)Middle AgedDebulkingPrognosisAdenocarcinoma MucinousOVARIAN CANCERSurvival Ratemedicine.anatomical_structureOncologyLymphatic MetastasisAdenocarcinomaFemaleAdultmedicine.medical_specialtyCystadenocarcinomaAdenocarcinomaAdenocarcinoma Clear Cell; Adenocarcinoma Mucinous; Adult; Aged; Aged 80 and over; Cystadenocarcinoma Serous; Endometrial Neoplasms; Female; Follow-Up Studies; Humans; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Mesentery; Middle Aged; Neoplasm Grading; Ovarian Neoplasms; Prognosis; Rectum; Retrospective Studies; Sigmoid Neoplasms; Survival Rate; Surgery; OncologyInternal medicinemedicineHumansSurvival rateAgedRetrospective Studiesbusiness.industryRectumSerousRetrospective cohort studymedicine.diseaseCystadenocarcinoma SerousEndometrial NeoplasmsSigmoid NeoplasmsSettore MED/40 - GINECOLOGIA E OSTETRICIALymph Node ExcisionSurgeryLymph NodesNeoplasm GradingOvarian cancerbusinessAdenocarcinoma Clear CellFollow-Up Studies

description

Background: The aim of this retrospective study was to investigate the incidence of mesenteric lymph node (MLN) involvement, and its prognostic role in advanced ovarian cancer (OC). Methods: OC patients undergoing rectosigmoid resection during primary debulking surgery or interval debulking surgery were recorded. Progression-free survival (PFS) and overall survival were calculated from the date of diagnosis to the date of relapse/progression, death of disease, or the date of last follow-up. Results: MLNs were detected in 102/148 cases (68.9 %); the rate of MLN involvement was 47.0 %. The percentage of metastatic MLNs was higher in cases with >5 MLNs removed compared with cases with ≤5 MLNs removed (62.7 % vs. 31.3 %; p = 0.0027). A progressive increase in the rate of metastatic MLNs was documented in association with depth of bowel infiltration (p = 0.026). Cases with metastatic MLNs experienced isolated celiac trunk or aortic lymph node recurrences more frequently than patients without MLN involvement (44.8 % vs. 10.7 %; p = 0.0008). PFS did not differ between cases with positive versus negative MLN involvement (2-year PFS = 31 % vs. 43 %; p = 0.58). Conclusion: OC patients undergoing rectosigmoid resection showed metastatic MLN involvement in 47.0 % of cases. Metastatic MLN status is associated with a high rate of isolated aortic and celiac trunk lymph node recurrences. © 2014 Society of Surgical Oncology.

yearjournalcountryeditionlanguage
2014-01-01
10.1245/s10434-014-3558-0http://hdl.handle.net/10807/57120