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. 2022 Sep:23:101476.
doi: 10.1016/j.tranon.2022.101476. Epub 2022 Jul 4.

Evaluation of the prognostic value of lymphadenectomy for low-grade serous ovarian cancer: A case-control multicenter retrospective study

Zhongshao Chen  1 , Ran Chu  1 , Yuanming Shen  2 , Qin Yao  3 , Jingying Chen  4 , Tianyu Qin  5 , Li Li  6 , Gang Chen  5 , Qinglei Gao  5 , Chaoyang Sun  5 , Li Song  6 , Junting Li  1 , Penglin Liu  1 , Xiyu Pan  1 , Jingnan Li  2 , Xiaoying Zhu  3 , Li Zhang  5 , Xu Qiao  7 , Ding Ma  5 , Beihua Kong  6 , Kun Song  8
Affiliations

Evaluation of the prognostic value of lymphadenectomy for low-grade serous ovarian cancer: A case-control multicenter retrospective study

Zhongshao Chen et al. Transl Oncol. 2022 Sep.

Abstract

Background: The prognostic value of lymphadenectomy in low-grade serous ovarian cancer (LGSOC) remains uncertain.

Materials and methods: A retrospective analysis of 155 patients with LGSOC who underwent surgery over a ten-year period (2011-2020) was performed. The propensity score matching (PSM) algorithm was performed between the lymphadenectomy and no lymphadenectomy groups, and Kaplan-Meier analyses were conducted to evaluate clinical prognosis. Finally, univariate and multivariate Cox proportional hazards regression analyses were performed to analyze high-risk factors associated with clinical prognosis.

Results: In the pre-PSM cohort, 110 (71.0%) patients underwent lymphadenectomy. Of these, 54 (34.8%) experienced recurrence, and 27 (17.4%) died. There were statistical differences in disease-free survival (DFS) (P = 0.018) and overall survival (OS) (P = 0.016) in the post-PSM cohort. In the subgroup analysis, there were no statistically significant differences in DFS (P = 0.449) or OS (P = 0.167) in the FIGO I/II cohort. However, in the FIGO III/IV cohort, DFS (P = 0.011) and OS (P = 0.046) were statistically different between the two groups. Age > 50 years, FIGO stage III/IV, and suboptimal cytoreductive surgery were risk factors associated with prognosis. In the lymphadenectomy group, the histological status of pelvic lymph nodes had no significant effect on DFS (P = 0.205) or OS (P = 0.114).

Conclusion: Lymphadenectomy was associated with DFS and OS, particularly in patients with advanced LGSOC patients. Age > 50 years, advanced FIGO stage III/IV, and suboptimal cytoreductive surgery were high-risk factors associated with clinical prognosis in patients with LGSOC.

Keywords: Disease-free survival; Low-grade serous ovarian cancer; Lymphadenectomy; Overall survival.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

Fig 1
Fig. 1
Kaplan-Meier curves for the pre- and post-PSM cohorts. (A, B) In the pre-PSM cohort, Kaplan-Meier survival analysis revealed that lymphadenectomy had a protective effect on DFS and OS. (C, D) After clinical characteristic matching, we found statistical differences in DFS and OS between the two groups.
Fig 2
Fig. 2
Kaplan-Meier curves of patients with FIGO stage I and II disease in the pre- and post-PSM cohorts. (A, B) In the pre-PSM cohort, Kaplan-Meier survival analysis revealed that lymphadenectomy may have a protective effect on OS. (C, D) After matching, we found no significant survival benefit from lymphadenectomy.
Fig 3
Fig. 3
Kaplan-Meier curves of patients with FIGO stage III and IV disease in the pre- and post-PSM cohorts. (A, B) In the pre-PSM cohort, Kaplan-Meier survival analysis revealed that lymphadenectomy had a protective effect on DFS and OS. (C, D) After matching, we found statistical differences in DFS and OS between the two groups.
See this image and copyright information in PMC

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