Lymphadenectomy in clinically early epithelial ovarian cancer and survival analysis (LILAC): a Gynecologic Oncology Research Investigators Collaboration (GORILLA-3002) retrospective study
- Abstract
- Objective: This study aimed to evaluate the therapeutic role of lymphadenectomy in patients surgically treated for clinically early-stage epithelial ovarian cancer (EOC).
Methods: This retrospective, multicenter study included patients with clinically early-stage EOC based on preoperative abdominal-pelvic computed tomography or magnetic resonance imaging findings between 2007 and 2021. Oncologic outcomes and perioperative complications were compared between the lymphadenectomy and non-lymphadenectomy groups. Independent prognostic factors were determined using Cox regression analysis. Disease-free survival (DFS) was the primary outcome. Overall survival (OS) and perioperative outcomes were the secondary outcomes.
Results: In total, 586 patients (lymphadenectomy group, n=453 [77.3%]; non-lymphadenectomy groups, n=133 [22.7%]) were eligible. After surgical staging, upstaging was identified based on the presence of lymph node metastasis in 14 (3.1%) of 453 patients. No significant difference was found in the 5-year DFS (88.9% vs. 83.4%, p=0.203) and 5-year OS (97.2% vs. 97.7%, p=0.895) between the two groups. Using multivariable analysis, lymphadenectomy was not significantly associated with DFS or OS. However, using subgroup analysis, the lymphadenectomy group with serous histology had higher 5-year DFS rates than did the non-lymphadenectomy group (86.5% vs. 74.4%, p=0.048; adjusted hazard ratio=0.281; 95% confidence interval=0.107-0.735; p=0.010). The lymphadenectomy group had longer operating time (p<0.001), higher estimated blood loss (p<0.001), and higher perioperative complication rate (p=0.004) than did the non-lymphadenectomy group.
Conclusion: In patients with clinically early-stage EOC with serous histology, lymphadenectomy was associated with survival benefits. Considering its potential harm, lymphadenectomy should be performed according to histologic subtype and subsequent chemotherapy in patients with clinically early-stage EOC.
Trial registration: Clinical Research Information Service Identifier: KCT0007309.
- All Author(s)
- Eun Jung Yang
; A Jin Lee
; Woo Yeon Hwang
; Suk-Joon Chang
; Hee Seung Kim
; Nam Kyeong Kim
; Yeorae Kim
; Tae Wook Kong
; Eun Ji Lee
; Soo Jin Park
; Joo-Hyuk Son
; Dong Hoon Suh
; Dong Hee Son
; Seung-Hyuk Shim
- Issued Date
- 2024
- Type
- Article
- Keyword
- Lymph Node Excision; Ovarian Epithelial Carcinoma; Prognosis; Quality of Life
- Publisher
- 대한부인종양콜포스코피학회
Korean Society of Gynecologic Oncology and Colposcopy
- ISSN
- 2005-0380
; 2005-0399
- Citation Title
- Journal of gynecologic oncology
- Citation Volume
- 35
- Citation Number
- 6
- Citation Start Page
- e75
- Citation End Page
- e75
- Language(ISO)
- eng
- DOI
- 10.3802/jgo.2024.35.e75
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/3479
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