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Comparative Study
. 2011 Aug 9;105(4):493-7.
doi: 10.1038/bjc.2011.267. Epub 2011 Jul 19.

Prognostic impact of lymphadenectomy in clinically early stage malignant germ cell tumour of the ovary

H Mahdi  1 , R E Swensen, R Hanna, S Kumar, R Ali-Fehmi, A Semaan, H Tamimi, R T Morris, A R Munkarah
Affiliations
Comparative Study

Prognostic impact of lymphadenectomy in clinically early stage malignant germ cell tumour of the ovary

H Mahdi et al. Br J Cancer. .

Abstract

Background: The aim of this study was to determine the impact of lymphadenectomy and nodal metastasis on survival in clinical stage I malignant ovarian germ cell tumour (OGCT).

Methods: Data were obtained from the National Cancer Institute registry from 1988 to 2006. Analyses were performed using Student's t-test, Kaplan-Meier and Cox proportional hazard methods.

Results: In all, 1083 patients with OGCT who have undergone surgical treatment and deemed at time of the surgery to have disease clinically confined to the ovary were included 590 (54.48%) had no lymphadenectomy (LND-1) and 493 (45.52%) had lymphadenectomy. Of the 493 patients who had lymphadenectomy, 441 (89.5%) were FIGO surgical stage I (LND+1) and 52 (10.5%) were upstaged to FIGO stage IIIC due to nodal metastasis (LND+3C). The 5-year survival was 96.9% for LND-1, 97.7% for LND+1 and 93.4% for LND+3C (P=0.5). On multivariate analysis, lymphadenectomy was not an independent predictor of survival when controlling for age, histology and race (HR: 1.26, 95% CI: 0.62-2.58, P=0.5). Moreover, the presence of lymph node metastasis had no significant effect on survival (HR: 2.7, 95% CI: 0.67-10.96, P=0.16).

Conclusion: Neither lymphadenectomy nor lymph node metastasis was an independent predictor of survival in patients with OGCT confined to the ovary. This probably reflects the highly chemosensitive nature of these tumours.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Survival comparison among clinical stage I OGCT (LND−1), histologically node negative stage I OGCT (LND+1) and histologically node positive stage IIIC OGCT (LND+3C). Kaplan–Meier curves for the difference in overall survival between LND−1, LND+1 and LND+3C. Overall 5-year survival was 96.9% for LND−1, 97.7% for LND+1 and 93.4% for LND+3C (P=0.5).
Figure 2
Figure 2
Survival comparison among clinical stage I dysgerminoma (LND−1), histologically node negative stage I dysgerminoma (LND+1) and histologically node positive stage IIIC dysgerminoma (LND+3C). Kaplan–Meier curves for the difference in overall survival between LND−1, LND+1 and LND+3C. Overall 5-year survival was 97.9% for LND−1, 97.5% for LND+1 and 97.5% for LND+3C (P=0.92).
Figure 3
Figure 3
Survival comparison among clinical stage I MT (LND−1), histologically node negative stage I MT (LND+1) and histologically node positive stage IIIC MT (LND+3C). Kaplan–Meier curves for the difference in overall survival between LND−1, LND+1 and LND+3C. Overall 5-year survival was 96.8% for LND−1, 98.6% for LND+1 and 83.3% for LND+3C (P=0.38).
Figure 4
Figure 4
Survival comparison among clinical stage I MGCT/PNDCT (LND−1), histologically node negative stage I MGCT/PNDCT (LND+1) and histologically node positive stage IIIC MGCT/PNDCT (LND+3C). Kaplan–Meier curves for the difference in overall survival between LND−1, LND+1 and LND+3C. Overall 5-year survival was 92.4% for LND−1, 96.3% for LND+1 and 75% for LND+3C (P=0.1).
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References

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