The prognostic impact of celiac lymph node involvement in advanced ovarian cancer

This study aimed to assess the prognostic impact of celiac lymph node involvement in patients with advanced high-grade serous ovarian cancer.

We conducted a retrospective, single-center study including patients who underwent celiac lymph node resection during either upfront or interval complete cytoreductive surgery as frontline treatment for advanced high-grade serous ovarian cancer between January 2002 and December 2022. Patients were categorized into 2 groups based on celiac lymph node status. Univariable and multi-variable analyses were performed, and survival rates were estimated using the Kaplan-Meier method.

Among 820 patients who underwent cytoreductive surgery for ovarian cancer during the study period, 65 (7.9%) had celiac lymph node resection and were included. Celiac lymph node metastases were identified in 42 (64.6%) cases. Celiac lymph node-positive patients had a higher tumor burden (p =.001), more frequent bowel involvement (p =.026), and higher rates of left hemicolectomy (17.1% vs 0.0%) and inguinal lymphadenectomy (16.7% vs 0.0%). Median overall survival was 30.9 months in the celiac lymph node-positive group and 50.6 months in the celiac lymph node-negative group (p =.270); median disease-free survival was 10.8 and 14.6 months (p =.082), respectively. In multi-variable analysis, celiac lymph node involvement was significantly associated with decreased disease-free survival (hazard ratio 2.87 [1.38 to 5.93], p =.005).

Celiac lymph node involvement is associated with a higher tumor burden and significantly associated with a decrease in disease-free survival in cases of advanced high-grade serous ovarian cancer. These results highlight the need to identify celiac lymph node involvement for better risk stratification.