Evaluation of the prognostic value of lymphadenectomy for low-grade serous ovarian cancer: A case-control multicenter retrospective study

Zhongshao Chen; Ran Chu; Yuanming Shen; Qin Yao; Jingying Chen; Tianyu Qin; Li Li; Gang Chen; Qinglei Gao; Chaoyang Sun; Li Song; Junting Li; Penglin Liu; Xiyu Pan; Jingnan Li; Xiaoying Zhu; Li Zhang; Xu Qiao; Ding Ma; Beihua Kong; Kun Song

doi:10.1016/j.tranon.2022.101476

Evaluation of the prognostic value of lymphadenectomy for low-grade serous ovarian cancer: A case-control multicenter retrospective study

Transl Oncol. 2022 Sep:23:101476. doi: 10.1016/j.tranon.2022.101476. Epub 2022 Jul 4.

Authors

Zhongshao Chen¹, Ran Chu¹, Yuanming Shen², Qin Yao³, Jingying Chen⁴, Tianyu Qin⁵, Li Li⁶, Gang Chen⁵, Qinglei Gao⁵, Chaoyang Sun⁵, Li Song⁶, Junting Li¹, Penglin Liu¹, Xiyu Pan¹, Jingnan Li², Xiaoying Zhu³, Li Zhang⁵, Xu Qiao⁷, Ding Ma⁵, Beihua Kong⁶, Kun Song⁸

Affiliations

¹ Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China.
² Department of Gynecology, Women's Hospital School, Medicine Zhejiang University, Hangzhou, Zhejiang, PR China.
³ Department of Gynecology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China.
⁴ Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China; Gynecology oncology key laboratory, Qilu Hospital of Shandong University, Jinan, Shandong, PR China.
⁵ Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
⁶ Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, PR China; Gynecology oncology key laboratory, Qilu Hospital of Shandong University, Jinan, Shandong, PR China.
⁷ School of Control Science and Engineering, Shandong University, Jinan, Shandong, PR China.
⁸ Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, PR China; Gynecology oncology key laboratory, Qilu Hospital of Shandong University, Jinan, Shandong, PR China. Electronic address: songkun2001226@sdu.edu.cn.

Abstract

Background: The prognostic value of lymphadenectomy in low-grade serous ovarian cancer (LGSOC) remains uncertain.

Materials and methods: A retrospective analysis of 155 patients with LGSOC who underwent surgery over a ten-year period (2011-2020) was performed. The propensity score matching (PSM) algorithm was performed between the lymphadenectomy and no lymphadenectomy groups, and Kaplan-Meier analyses were conducted to evaluate clinical prognosis. Finally, univariate and multivariate Cox proportional hazards regression analyses were performed to analyze high-risk factors associated with clinical prognosis.

Results: In the pre-PSM cohort, 110 (71.0%) patients underwent lymphadenectomy. Of these, 54 (34.8%) experienced recurrence, and 27 (17.4%) died. There were statistical differences in disease-free survival (DFS) (P = 0.018) and overall survival (OS) (P = 0.016) in the post-PSM cohort. In the subgroup analysis, there were no statistically significant differences in DFS (P = 0.449) or OS (P = 0.167) in the FIGO I/II cohort. However, in the FIGO III/IV cohort, DFS (P = 0.011) and OS (P = 0.046) were statistically different between the two groups. Age > 50 years, FIGO stage III/IV, and suboptimal cytoreductive surgery were risk factors associated with prognosis. In the lymphadenectomy group, the histological status of pelvic lymph nodes had no significant effect on DFS (P = 0.205) or OS (P = 0.114).

Conclusion: Lymphadenectomy was associated with DFS and OS, particularly in patients with advanced LGSOC patients. Age > 50 years, advanced FIGO stage III/IV, and suboptimal cytoreductive surgery were high-risk factors associated with clinical prognosis in patients with LGSOC.

Keywords: Disease-free survival; Low-grade serous ovarian cancer; Lymphadenectomy; Overall survival.