Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Feb 27;16(5):955.
doi: 10.3390/cancers16050955.

The Role of Systematic Lymphadenectomy in Low-Grade Serous Ovarian Cancer: A Systematic Review and Meta-Analysis

Rosa Montero-Macías  1 , Juan José Segura-Sampedro  2   3   4 , Pascal Rigolet  5 , Fabrice Lecuru  6   7 , Andrea Craus-Miguel  4   8 , Juan Manuel Castillo-Tuñón  9
Affiliations
Review

The Role of Systematic Lymphadenectomy in Low-Grade Serous Ovarian Cancer: A Systematic Review and Meta-Analysis

Rosa Montero-Macías et al. Cancers (Basel). .

Abstract

Objective: To evaluate the role of systematic lymphadenectomy in low-grade serous ovarian cancer (LGSOC) and determine its impact on clinical outcomes in overall survival (OS) and disease-free survival (DFS) terms.

Methods: A comprehensive, systematic computer literature search on PubMed was performed using the following Medical Subject Headings (MeSH) terms: "low grade serous ovarian cancer" AND/OR "lymphadenectomy" AND/OR "staging" AND/OR "ovarian cancer" AND/OR "cytoreduction". Separate searches were performed with MeSH terms on MEDLINE and EMBASE to extract all the relevant literature available. We included only patients with histologically confirmed LGSOC.

Results: Three studies were considered in the quantitative analysis. Systematic lymphadenectomy in LGSOC failed to provide a significant OS or PFS benefit in LGSOC when compared to no lymphadenectomy in the entire (all the stages) population (for OS: HR = 1.15, 95% CI [0.42, 3.18] I2 = 84% and for PFS: HR = 1.46, 95% CI [0.63, 3.41], I2 = 71%), nor did it in the subtype analysis regarding FIGO stages. For FIGO early-stage I-II LGSOC, the DFS data were pooled (HR = 1.48, 95% CI [0.58, 3.78], I2 = 75%). In patients with advanced-stage (FIGO II-IV), we also failed to prove survival benefit for lymphadenectomy in OS (HR = 1.74, 95% CI [0.87, 3.48], I2 = 11%) or DFS (HR = 1.48, 95% CI [0.58, 3.78], I2 = 75%) compared to no lymphadenectomy.

Conclusion: More extensive prospective research is mandatory to understand the real impact of lymphadenectomy on survival in LGSOC. The existing literature does not provide strong evidence.

Keywords: low-grade ovarian cancer; lymphadenectomy; overall survival; period-free disease.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA [18] flow diagram.
Figure 2
Figure 2
Meta–analysis for (a) OS in whole LGSOC population regarding systematic lymphadenectomy, (b) DFS in whole LGSOC population regarding systematic lymphadenectomy, (c) DFS in early-stage FIGO I–II LGSOC regarding systematic lymphadenectomy, (d) OS in advanced-stage FIGO III–IV LGSOC regarding systematic lymphadenectomy, and (e) for DFS in advanced-stage FIGO III–IV LGSOC regarding systematic lymphadenectomy. References: [19,20,21].
See this image and copyright information in PMC

References

    1. Cabasag C.J., Fagan P.J., Ferlay J., Vignat J., Laversanne M., Liu L., van der Aa M.A., Bray F., Soerjomataram I. Ovarian Cancer Today and Tomorrow: A Global Assessment by World Region and Human Development Index Using GLOBOCAN 2020. Int. J. Cancer. 2022;151:1535–1541. doi: 10.1002/ijc.34002. - DOI - PubMed
    1. Malpica A., Deavers M.T., Lu K., Bodurka D.C., Atkinson E.N., Gershenson D.M., Silva E.G. Grading Ovarian Serous Carcinoma Using a Two-Tier System. Am. J. Surg. Pathol. 2004;28:496–504. doi: 10.1097/00000478-200404000-00009. - DOI - PubMed
    1. Zantow E., Chen A., Zhao D., Mashburn S., Underwood H., Baste Subia M.N., Zuna R., Moore K.N., Holman L.L. Clinical Factors Associated with Short- and Long-Term Survival in Low Grade Ovarian Carcinoma. Gynecol. Oncol. 2017;147:216. doi: 10.1016/j.ygyno.2017.07.071. - DOI
    1. Gadducci A., Cosio S. Therapeutic Approach to Low-Grade Serous Ovarian Carcinoma: State of Art and Perspectives of Clinical Research. Cancers. 2020;12:1336. doi: 10.3390/cancers12051336. - DOI - PMC - PubMed
    1. Kumar A., Cliby W.A. Advanced Ovarian Cancer: Weighing the Risks and Benefits of Surgery. Clin. Obstet. Gynecol. 2020;63:74–79. doi: 10.1097/GRF.0000000000000497. - DOI - PubMed

LinkOut - more resources