TY - JOUR
T1 - The impact of systematic retroperitoneal lymphadenectomy on long-term oncologic outcome of women with advanced ovarian clear-cell carcinoma
AU - Kajiyama, Hiroaki
AU - Suzuki, Shiro
AU - Yoshikawa, Nobuhisa
AU - Tamauchi, Satoshi
AU - Shibata, Kiyosumi
AU - Kikkawa, Fumitaka
N1 - Funding Information:
We sincerely thank Drs. Y. Kimio Mizuno (Nagoya First Red Cross Hospital), K. Sakakibara (Okazaki Municipal Hospital), S. Yamamuro (Nagoya Second Red Cross Hospital), T. Misawa (Nagoya Ekisaikai Hospital), M. Kawai (Toyohashi Municipal Hospital), H. Oguchi (Toyota Memorial Hospital), and T. Suzuki (Anjyo Kosei Hospital) who collaborated in data collection. We sincerely thank Dr. Tetsuro Nagasaka (Nagoya University) who collaborated in central pathological review.
Publisher Copyright:
© 2020. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.
PY - 2020/7
Y1 - 2020/7
N2 - Objective: The impact of systematic retroperitoneal lymphadenectomy (SRL) remains controversial in patients with advanced ovarian clear-cell carcinoma (CCC) who are optimally debulked. Methods: Between 1986 and 2017, a total of 3,227 women with epithelial ovarian carcinoma were analyzed in a multi-institutional study. Among them, 166 optimally debulked women with stage IIB–IV CCC were collected (residual tumor of <1 cm). All patients were divided into 2 groups: 1) Group I (n=112): underwent standard radical surgery with SRL, 2) Group II (n=54): underwent non-staging limited surgery. The pathological slides were assessed based on central pathological review. Oncologic outcomes were compared between the two groups using a propensity score (PS)-matching technique to adjust for various clinicopathologic factors. Results: The median follow-up duration of all surviving women was 52.8 (1.6–184.2) months. Overall, 88 patients (53.0%) experienced recurrence and 68 patients (41.0%) died of the disease. In the original cohort, the 5-year overall survival (OS) rates of groups I and II were 57.9 and 64.9%, respectively (log-rank p=0.415). In the PS-adjusted cohort, the 5-year OS rates were 64.9 and 58.8% in women in groups I and II, respectively (p=0.453). Furthermore, in the PS-matched cohort after adjustment for multiple clinicopathologic factors, there was no significant difference in OS between the 2 groups (group I vs. group II; hazard ratio=1.170; 95% confidence interval=0.633–2.187; p=0.615). Conclusions: This study suggests that the performance of SRL including radical surgery may not lead to a significant improvement in the oncologic outcome of advanced CCC patients with optimal cytoreduction.
AB - Objective: The impact of systematic retroperitoneal lymphadenectomy (SRL) remains controversial in patients with advanced ovarian clear-cell carcinoma (CCC) who are optimally debulked. Methods: Between 1986 and 2017, a total of 3,227 women with epithelial ovarian carcinoma were analyzed in a multi-institutional study. Among them, 166 optimally debulked women with stage IIB–IV CCC were collected (residual tumor of <1 cm). All patients were divided into 2 groups: 1) Group I (n=112): underwent standard radical surgery with SRL, 2) Group II (n=54): underwent non-staging limited surgery. The pathological slides were assessed based on central pathological review. Oncologic outcomes were compared between the two groups using a propensity score (PS)-matching technique to adjust for various clinicopathologic factors. Results: The median follow-up duration of all surviving women was 52.8 (1.6–184.2) months. Overall, 88 patients (53.0%) experienced recurrence and 68 patients (41.0%) died of the disease. In the original cohort, the 5-year overall survival (OS) rates of groups I and II were 57.9 and 64.9%, respectively (log-rank p=0.415). In the PS-adjusted cohort, the 5-year OS rates were 64.9 and 58.8% in women in groups I and II, respectively (p=0.453). Furthermore, in the PS-matched cohort after adjustment for multiple clinicopathologic factors, there was no significant difference in OS between the 2 groups (group I vs. group II; hazard ratio=1.170; 95% confidence interval=0.633–2.187; p=0.615). Conclusions: This study suggests that the performance of SRL including radical surgery may not lead to a significant improvement in the oncologic outcome of advanced CCC patients with optimal cytoreduction.
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U2 - 10.3802/jgo.2020.31.e47
DO - 10.3802/jgo.2020.31.e47
M3 - Article
C2 - 32026661
AN - SCOPUS:85086346635
VL - 31
SP - 1
EP - 11
JO - Journal of Gynecologic Oncology
JF - Journal of Gynecologic Oncology
SN - 2005-0380
IS - 4
M1 - e47
ER -