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Clinical Significance of Mesenteric Lymph Node Involvement in the Pattern of Liver Metastasis in Patients with Ovarian Cancer

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Mesenteric lymph node (MLN) involvement is often observed in ovarian cancer (OC) with rectosigmoid invasion. This study aimed to investigate the clinical significance of MLN involvement in the pattern of liver metastasis in patients with OC.

Methods

We included 85 stage II–IV OC patients who underwent primary or interval debulking surgery. Twenty-seven patients underwent rectosigmoid resection, whose status of MLN involvement was judged from hematoxylin and eosin (H&E) staining of resected specimens. The prognostic significance of clinicopathological characteristics, including MLN involvement, was evaluated using univariate and multivariate analyses.

Results

MLN involvement was detected in 14/85 patients with stage II–IV OC. Residual tumor status, cytology of ascites, and MLN involvement were independent prognostic factors for progression-free survival (PFS; p = 0.033, p = 0.014, and p = 0.008, respectively). When patients were classified into three groups (no MLN, one MLN, two or more MLNs), the number of MLNs involved corresponded to three distinct groups in PFS (p = 0.001). The 3-year cumulative incidence of liver metastasis of patients with MLN involvement was significantly higher than that of patients without MLN involvement (61.1% vs. 8.9%, p < 0.001). MLN involvement was significantly associated with liver metastasis of hematogenous origin (p < 0.001) compared with peritoneal disseminated origin.

Conclusion

MLN involvement is an important prognostic factor in OC, predicting poor prognosis and liver metastasis of hematogenous origin.

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Funding

This research was supported by JSPS KAKENHI Grant Number JP19K09116 (MN, YS, HK, TW, KN, TE, KY, and KT).

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Authors and Affiliations

  1. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Kana Tanaka MD, Yoshifumi Shimada MD, PhD, Masato Nakano MD, PhD, Hitoshi Kameyama MD, PhD & Toshifumi Wakai MD, PhD, FACS

  2. Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Koji Nishino MD, PhD, Kosuke Yoshihara MD, PhD & Takayuki Enomoto MD, PhD

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Correspondence to Yoshifumi Shimada MD, PhD.

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Disclosure

Kana Tanaka, Yoshifumi Shimada, Koji Nishino, Kosuke Yoshihara, Masato Nakano, Hitoshi Kameyama, Takayuki Enomoto and Toshifumi Wakai has nothing to disclose.

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Tanaka, K., Shimada, Y., Nishino, K. et al. Clinical Significance of Mesenteric Lymph Node Involvement in the Pattern of Liver Metastasis in Patients with Ovarian Cancer. Ann Surg Oncol 28, 7606–7613 (2021). https://doi.org/10.1245/s10434-021-09899-8

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