Clinical significance of para-aortic lymph node dissection and prognosis in ovarian cancer

• Published in: Frontiers of medicine 2014-03, Vol.8 (1), p.96-100
• Main Authors: Li, Xianxian, Xing, Hui, Li, Lin, Huang, Yanli, Zhou, Min, Liu, Qiong, Qin, Xiaomin, He, Min
• Format: Article
• Language: English
• Subjects: Aorta, Abdominal; Biopsy; Clinical significance; Dissection; Female; Humans; Lymph Node Excision - mortality; Lymph Node Excision - statistics & numerical data; Lymphatic Metastasis - pathology; Lymphatic system; Medical prognosis; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Ovarian cancer; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; para-aortic lymph node; pelvic lymph node; Prognosis; Proportional Hazards Models; Research Article; Survival Analysis; 临床意义; 卵巢癌; 淋巴结; 生存率; 相关性分析; 肿瘤细胞; 腹主动脉; 预后
• ISSN: 2095-0217; 2095-0225
• DOI: 10.1007/s11684-014-0316-4

Lymph node metastasis has an important effect on prognosis of patients with ovarian cancer. Moreover, the impact of para-aortic lymph node （PAN） removal on patient prognosis is still unclear. In this study, 80 patients were divided into groups A and B. Group A consisted of 30 patients who underwent PAN ＋ pelvic lymph node （PLN） dissection, whereas group B consisted of 50 patients who only underwent PLN dissection. Analysis of the correlation between PAN clearance and prognosis in epithelial ovarian cancer was conducted. Nineteen cases of lymph node metastasis were found in group A, among whom seven cases were positive for PAN, three cases for PLN, and nine cases for both PAN and PLN. In group B, 13 cases were positive for lymph node metastasis. Our study suggested that the metastatic rate of lymph node is 40.0%. Lymph node metastasis was significantly correlated with FIGO stage, tumor differentiation, and histological type both in groups A and B （P 〈 0.05）. In groups A and B, the three-year survival rates were 77.9% and 69.0%, and the five-year survival rates were 46.7% and 39.2%, respectively. However, the difference was not statistically significant （P 〉 0.05）. The three-year survival rates of PLN metastasis in groups A and B were 68.5% and 41.4%, and the five-year survival rates were 49.7% and 26.4%, respectively. Furthermore, PLN-positive patients who cleared PAN had significantly higher survival rate （P = 0.044）. In group A, the three-year survival rates of positive and negative lymph nodes were 43.5% and 72.7%, and the five-year survival rates were 27.2% and 58.5%, respectively. The difference was statistically significant （P= 0.048）. Cox model analysis of single factor suggested that lymph node status affected the survival rate （P 〈 0.01）, which was the death risk factor. Consequently, in ovarian carcinoma cytoreductive surgery, resection of the para-aortic lymph node, which has an important function in clinical treatment and prognosis of patients with ovarian cancer, is necessary.