Impact of lymphadenectomy and intra-operative tumor rupture on survival in early-stage mucinous ovarian cancers
© IGCS and ESGO 2023. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVE: Mucinous ovarian carcinoma is a rare subtype of epithelial ovarian cancer with scarce literature guiding its management. We aimed to investigate the optimal surgical management of clinical stage I mucinous ovarian carcinoma by examining the prognostic significance of lymphadenectomy and intra-operative rupture on patient survival.
METHODS: We conducted a retrospective cohort study of all pathology-reviewed invasive mucinous ovarian carcinomas diagnosed between 1999 and 2019 at two tertiary care cancer centers. Baseline demographics, surgical management details, and outcomes were collected. Five-year overall survival, recurrence-free survival, and the association of lymphadenectomy and intra-operative rupture on survival were examined.
RESULTS: Of 170 women with mucinous ovarian carcinoma, 149 (88%) had clinical stage I disease. Forty-eight (32%; n=149) patients had a pelvic and/or para-aortic lymphadenectomy, but only 1 patient with grade 2 disease was upstaged due to positive pelvic lymph nodes. Intra-operative tumor rupture was documented in 52 cases (35%). On multivariable analysis, after adjusting for age, final stage, and use of adjuvant chemotherapy, there was no significant association between intra-operative rupture with overall survival (HR 2.2 (0.6-8.0); p=0.3) or recurrence-free survival (HR 1.3 (0.5-3.3); p=0.6), or lymphadenectomy with overall survival (HR 0.9 (0.3-2.8); p=0.9) or recurrence-free survival (HR 1.2 (0.5-3.0); p=0.7). Advanced stage was the only factor that was significantly associated with survival.
CONCLUSIONS: In clinical stage I mucinous ovarian carcinoma, systematic lymphadenectomy has low utility, as very few patients are upstaged and recurrence typically occurs in the peritoneum. Furthermore, intra-operative rupture does not appear to independently confer a worse survival, and therefore these women may not benefit from adjuvant treatment based on rupture alone.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society - 33(2023), 5 vom: 01. Mai, Seite 755-760 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kim, Soyoun Rachel [VerfasserIn] |
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| Anmerkungen: |
Date Completed 03.05.2023 Date Revised 10.05.2023 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/ijgc-2023-004327 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354197576 |
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| 100 | 1 | |a Kim, Soyoun Rachel |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of lymphadenectomy and intra-operative tumor rupture on survival in early-stage mucinous ovarian cancers |
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| 500 | |a Date Revised 10.05.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © IGCS and ESGO 2023. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVE: Mucinous ovarian carcinoma is a rare subtype of epithelial ovarian cancer with scarce literature guiding its management. We aimed to investigate the optimal surgical management of clinical stage I mucinous ovarian carcinoma by examining the prognostic significance of lymphadenectomy and intra-operative rupture on patient survival | ||
| 520 | |a METHODS: We conducted a retrospective cohort study of all pathology-reviewed invasive mucinous ovarian carcinomas diagnosed between 1999 and 2019 at two tertiary care cancer centers. Baseline demographics, surgical management details, and outcomes were collected. Five-year overall survival, recurrence-free survival, and the association of lymphadenectomy and intra-operative rupture on survival were examined | ||
| 520 | |a RESULTS: Of 170 women with mucinous ovarian carcinoma, 149 (88%) had clinical stage I disease. Forty-eight (32%; n=149) patients had a pelvic and/or para-aortic lymphadenectomy, but only 1 patient with grade 2 disease was upstaged due to positive pelvic lymph nodes. Intra-operative tumor rupture was documented in 52 cases (35%). On multivariable analysis, after adjusting for age, final stage, and use of adjuvant chemotherapy, there was no significant association between intra-operative rupture with overall survival (HR 2.2 (0.6-8.0); p=0.3) or recurrence-free survival (HR 1.3 (0.5-3.3); p=0.6), or lymphadenectomy with overall survival (HR 0.9 (0.3-2.8); p=0.9) or recurrence-free survival (HR 1.2 (0.5-3.0); p=0.7). Advanced stage was the only factor that was significantly associated with survival | ||
| 520 | |a CONCLUSIONS: In clinical stage I mucinous ovarian carcinoma, systematic lymphadenectomy has low utility, as very few patients are upstaged and recurrence typically occurs in the peritoneum. Furthermore, intra-operative rupture does not appear to independently confer a worse survival, and therefore these women may not benefit from adjuvant treatment based on rupture alone | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cystadenocarcinoma, Mucinous | |
| 650 | 4 | |a Lymph Nodes | |
| 700 | 1 | |a Madariaga, Ainhoa |e verfasserin |4 aut | |
| 700 | 1 | |a Hogen, Liat |e verfasserin |4 aut | |
| 700 | 1 | |a Vicus, Danielle |e verfasserin |4 aut | |
| 700 | 1 | |a Covens, Allan |e verfasserin |4 aut | |
| 700 | 1 | |a Parra-Herran, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Lheureux, Stephanie |e verfasserin |4 aut | |
| 700 | 1 | |a Gien, Lilian T |e verfasserin |4 aut | |
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