Objective: The purpose of this study was to determine prognostic factors that have an impact on overall survival and to assess the rational application of retroperitoneal lymphadenectomy in patients with epithelial ovarian cancer.
Methods: A retrospective review was performed of 131 patients treated between Jan.1990 and Dec.1998 in Union Hospital and Tongji Hospital. Survival was calculated by Kaplan-Meier method and comparison was performed using Log-rank test. Independent prognostic factors were identified by the COX proportional hazards regression model.
Results: Multivariate analysis showed that the age, stage, residual tumor, retroperitoneal lymphadenectomy and the number of courses of chemotherapy were the most important prognostic factors. The overall 5-year survival was 66% and 41% for patients who did and did not undergo lymphadenectomy, respectively (P < 0.01). But the survival rate could not be improved through retroperitoneal lymphadenectomy in the patients with early stage, advanced stage whose residual tumor > 2 cm and those with mucinous adenocarcinoma (P > 0.05). Among patients with advanced stage whose residual tumor < or = 2 cm, 5-year survival was 65% and 30% for patients who did and did not undergo lymphadenectomy, respectively (P < 0.01). Among patients with serous adenocarcinoma, 5-year survival was 61% and 31% for patients who did and did not undergo lymphadenectomy, respectively (P < 0.01).
Conclusions: The prognosis of the patients with epithelial ovarian cancer may be influenced by age, stage, residual tumor, retroperitoneal lymphadenectomy and the number of courses of chemotherapy. Although retroperitoneal lymphadenectomy could improve the survival rate, it should be carried out selectively.