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. 2022 Oct 16;29(10):7802-7815.
doi: 10.3390/curroncol29100617.

Lymphadenectomy Benefits Small Cell Carcinoma of Ovary: A Population-Based Analysis

Jing Wang  1 , Yan Ning  1 , Yan Du  1 , Yu Kang  1
Affiliations

Lymphadenectomy Benefits Small Cell Carcinoma of Ovary: A Population-Based Analysis

Jing Wang et al. Curr Oncol. .

Abstract

Small cell carcinoma of the ovary (SCCO) is a rare type of ovarian cancer with high aggressiveness. The optimal treatment modality remains elusive. This study aims to comprehensively investigate the survival impact of clinical characteristics and treatments including lymphadenectomy in SCCO. A retrospective cohort study was performed and included patients from the Surveillance, Epidemiology, and End Results (SEER) database. Data collected included demographics, therapeutic details, and pathologic characteristics. Propensity-score matching analysis (PSM) was carried out to balance baseline variables between SCCO and non-SCCO. Cox regression, Kaplan-Meier, and stratified analyses were conducted before and after PSM. After filtering, 80 records on SCCO and 39,662 records on non-SSCO were obtained. Patients with SCCO were more prone to present unilateral tumor (57.6% and 85.0%, p < 0.001), larger tumor size (>15 cm: 9.5% and 32.5%; 10-15 cm: 13.2% vs. 22.5%, p < 0.001), younger age (59.1 ± 14.91 vs. 37.2 ± 19.05; p < 0.001), single status (17.0% vs. 45.0%; p < 0.001), single malignant tumor in a lifetime (76.1% vs. 87.5%; p = 0.0244), and pathologic grade IV diseases (14.5% vs. 40.0%; p < 0.001) compared with non-SCCO. After balancing the baseline clinical characteristics with a 1:4 ratio PSM, a total of matched 72 patients with SCCO and 254 patients with non-SCCO were identified. The survival rate of SCCO was distinctly inferior to non-SCCO, particularly in FIGO I, II, and III stages. Lymphadenectomy was performed in 37 (51.39%) SCCO patients, of whom 12 (32.43%) were found to have pathologically positive lymph nodes. Lymphadenectomy was linked to favorable overall survival in SCCO, particularly in the advanced stage, and was also an independent prognostic factor, whereas lymphadenectomy did not reveal an edge in matched non-SCCO. There was a pronounced survival benefit for SCCO when at least 10 or more nodes were resected. Lymphadenectomy in a non-stage-dependent way should be considered and deserves further clinical validation to promote the overall survival in SCCO.

Keywords: SEER; lymphadenectomy; overall survival; propensity-score matching analysis; small cell carcinoma of the ovary.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of data selection.
Figure 2
Figure 2
Survival curves of overall survival among patients with SCCO and non-SCCO. All stages (A), stage I (B), stage II (C), stage III (D), and stage IV (E) in matched cohort.
Figure 3
Figure 3
Survival curves of overall survival among patients with all stage (A,B), early stage (C,D), and advanced stage (E,F) in non-SCCO and SCCO in matched cohort divided by lymphadenectomy.
Figure 4
Figure 4
Overall survival curves for non-SCCO (A) and SCCO (B) patients who underwent lymphadenectomy stratified by positive lymph node. Overall survival curves among patients with non-SCCO (C) and SCCO (D) stratified by the number of resected lymph nodes. Overall survival curves among patients with non-SCCO (E) and SCCO (F) stratified by LODDS.
See this image and copyright information in PMC

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