Nodal status-its impact on prognosis in advanced ovarian cancer

摘要

Purpose Prognostic impact of nodal status or lymphadenectomy in advanced ovarian cancer is still unclear. Known best prognostic impact in advanced ovarian cancer has the residual tumor mass. The aim of this retrospective study is to examine the importance of nodal status in correlation with residual tumor mass. Methods One hundred and Wfty-seven consecutive patients with primary stage III ovarian cancer underwent surgery between 01/2000 and 06/2007 at the Department of gynecology and obstetrics, University Hospital, Tübingen, Germany. All patients got stage-related surgery and platinbased chemotherapy. Median follow-up time was 53.5 months, and all patients were included in the study. Results Resection status and nodal status are signiWcant prognostic factors in our study (P < 0.001). In FIGO III, patients without residual tumor (R0) had signiWcant best OS and PFS independent to node status (N0/N+; P = 0.002) compared to patients with residual tumor. In contrast, node status had signiWcant positive impact on PFS in patients without residual tumor and node negativity. With theincrease in residual tumor, the inXuence of lymphnode metastases on prognosis is decreasing. Conclusion Main intention of primary surgery is R0 resection with best prognosis in advanced stages. A systematic lymphadenectomy in cases with R0 resection or residual tumor <1 cm seems to be reasonable with positive impact on prognosis. Node status has impact on prognosis in patients with negative node after R0 resection with best PFS in FIGO III. Further prospective studies had to show whether systematic lymphadenectomy in suboptimally tumor-reduced patients can improve prognosis.