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Published on: August 19, 2021
Lymph node-positive stage IIIC ovarian cancer: a separate entity?
1Department of Obstetrics and Gynecology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA. jberek@stanford.edu
Summary
Ovarian cancer retroperitoneal lymph node metastasis impacts survival. Patients with stage IIIC ovarian cancer and lymph node metastasis but no peritoneal carcinomatosis have better outcomes than those with carcinomatosis.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Pathology
Background:
- Ovarian cancer commonly metastasizes to retroperitoneal lymph nodes.
- Stage IIIC ovarian cancer diagnosis is influenced by retroperitoneal lymph node involvement.
- Retroperitoneal lymphadenectomy is performed during cytoreductive surgery for advanced ovarian cancer.
Purpose of the Study:
- To stratify patients with stage IIIC ovarian cancer based on lymph node and peritoneal metastasis.
- To evaluate the impact of retroperitoneal lymph node resection on survival in ovarian cancer.
Main Methods:
- Stratifying stage IIIC ovarian cancer patients by lymph node status and peritoneal disease extent.
- Analyzing survival data based on retroperitoneal lymph node resection during primary and secondary cytoreductive surgery.
Main Results:
- Overall survival for stage IIIC ovarian cancer with retroperitoneal lymph node metastasis but no peritoneal carcinomatosis ranges from 58% to 84%.
- Survival for those with macroscopic peritoneal carcinomatosis is significantly lower (18% to 36%).
- Secondary resection of isolated lymph node metastasis is associated with improved survival.
Conclusions:
- Stratification of stage IIIC ovarian cancer by lymph node metastasis and peritoneal carcinomatosis is supported.
- The International Federation of Gynecology and Obstetrics staging system may require modification for stage III disease.
- While primary lymphadenectomy may not improve survival, resection of isolated lymph node recurrences may offer a survival benefit.
