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Systematic Pelvic and Aortic Lymphadenectomy in Advanced Ovarian Cancer Patients at the Time of Interval Debulking Surgery: A Double-Institution Case–Control Study

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

Abstract

Background

The prognostic role of systematic lymphadenectomy remains unclear in advanced ovarian cancer (AOC). Only few retrospective case series have investigated the percentage of lymph node metastases after neoadjuvant chemotherapy. This multi-institutional case-control study analyzed the prognostic role of systematic lymphadenectomy in AOC patients at the time of interval debulking surgery (IDS).

Methods

From January 2005 to December 2010, the records of patients with AOC admitted to IDS at the Catholic University of Rome (n = 101, controls) and at the University of Bologna (n = 50, cases) were retrospectively analyzed. The cases, routinely submitted to systematic pelvic and aortic lymphadenectomy, were matched 1:2 with the controls, who did not routinely undergo lymphadenectomy. To correctly assess the prognostic role of lymphadenectomy, only patients with optimally debulked disease were included. Progression-free survival and overall survival were analyzed by a log-rank test.

Results

After an overall mean follow-up of 36 months (95 % confidence interval 33–39), 35 and 63 recurrences (70.0 vs. 62.4 %; p = NS) and 15 and 24 deaths due to disease (30 vs. 23.7 %; p = NS) were observed in the case and controls, respectively. The 2-year progression-free survival rate was 36 versus 25 % (p = 0.834), and the 2-year overall survival rate was 69 versus 88 % (p = 0.777), in the case and controls, respectively. The median operating time was longer, and the percentage of patients requiring blood transfusions was higher in the cases than in the controls (225 vs. 210 min, p = 0.023, and 54 vs. 22.8 %, p = 0.0001, respectively).

Conclusions

Lymphadenectomy at the time of IDS could be omitted, at least in high-risk patients.

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Acknowledgment

This study is not supported by any grant support.

Conflict of interest

The authors indicate no potential conflicts of interest.

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Authors and Affiliations

  1. Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy

    Anna Fagotti MD, PhD, Francesco Fanfani MD, Giuseppe Vizzielli MD, Federica Perelli MD, Luigi Carlo Turco MD & Giovanni Scambia MD

  2. Gynecology and Reproductive Medicine Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    Pierandrea De Iaco MD, Federica Pozzati MD & Anna Myriam Perrone MD

Authors
  1. Anna Fagotti MD, PhD
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  2. Pierandrea De Iaco MD
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  3. Francesco Fanfani MD
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  4. Giuseppe Vizzielli MD
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  5. Federica Perelli MD
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  6. Federica Pozzati MD
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  7. Anna Myriam Perrone MD
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  8. Luigi Carlo Turco MD
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  9. Giovanni Scambia MD
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Corresponding author

Correspondence to Anna Fagotti MD, PhD.

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Fagotti, A., De Iaco, P., Fanfani, F. et al. Systematic Pelvic and Aortic Lymphadenectomy in Advanced Ovarian Cancer Patients at the Time of Interval Debulking Surgery: A Double-Institution Case–Control Study. Ann Surg Oncol 19, 3522–3527 (2012). https://doi.org/10.1245/s10434-012-2400-9

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  • DOI: https://doi.org/10.1245/s10434-012-2400-9

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