Share This Article:

Efficacy of Para-Aortic Lymphadenectomy in Ovarian Cancer: A Retrospective Study

Abstract Full-Text HTML Download Download as PDF (Size:195KB) PP. 28-32
DOI: 10.4236/jct.2013.45A005    3,026 Downloads   4,720 Views  


Objective: The prognostic impact for ovarian cancer treatment of employing a systematic para-aortic and pelvic lymphadenectomy is still poorly defined. The purpose of this study was to evaluate the therapeutic efficacy of adding a para-aortic lymphadenectomy (PA) to the pelvic lymphadenectomy (PL), as compared with solely the pelvic lymphadenectomy. Materials and Methods: A retrospective study of patient outcomes was conducted of ovarian cancer patients who underwent optimal debulking surgery, concurrent with either PA + PL or PL alone, between 2000 and 2009 at our Osaka General Medical Center. Results: One hundred twenty-one patients with ovarian cancer underwent surgery. Forty-four patients (36%) underwent optimal debulking surgery (all residual disease was <1 cm) concurrent with lymphadenectomy. Seventeen patients underwent PA + PL (PA group), and 27 patients underwent PL alone (PL group). There were no significant differences in terms of overall survival (OS; hazard ratio [HR] = 0.49; 95% CI, 0.13 to 1.82; p = 0.29) and progression-free survival (PFS; HR = 0.62; 95% CI, 0.19 to 2.00; p = 0.40) between the PA group and the PL group. Both OS and PFS also failed to show significant differences, even when comparing them among 26 cases of FIGO stage I cases. Conclusions: Our data failed to show any prognostic improvement for ovarian cancer by adding para-aortic lymphadenectomy to the standard pelvic lymphadenectomy regimen.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

H. Ugaki, Y. Komoto, R. Kakubari, E. Tanaka, H. Konishi, T. Kitai, S. Nakajima, M. Muraji, T. Enomoto and M. Takemura, "Efficacy of Para-Aortic Lymphadenectomy in Ovarian Cancer: A Retrospective Study," Journal of Cancer Therapy, Vol. 4 No. 5A, 2013, pp. 28-32. doi: 10.4236/jct.2013.45A005.


[1] T. Matsuda, T. Marugame, K. I. Kamo, et al., “The Japan Cancer Surveillance Research Group. Cancer Incidence and Incidence Rates in Japan in 2005: Based on Data from 12 Population-Based Cancer Registries in the Monitoring of Cancer Incidence in Japan (MCIJ) Project,” Japanese Journal of Clinical Oncology, Vol. 41, No. 1, 2011, pp. 139-147. doi:10.1093/jjco/hyq169
[2] E. Burghardt, F. Girardi, M. Lahousen, et al., “Patterns of Pelvic and Paraaortic Lymph Node Involvement in Ovarian Cancer,” Gynecologic Oncology, Vol. 40, No. 2, 1991, pp. 103-106. doi:10.1016/0090-8258(91)90099-Q
[3] I. Cass, A. J. Li, C. D. Runowicz, et al., “Pattern of Lymph Node Metastases in Clinically Unilateral Stage I Invasive Epithelial Ovarian Carcinomas,” Gynecologic Oncology, Vol. 80, No. 1, 2001, pp. 56-61. doi:10.1006/gyno.2000.6027
[4] FIGO Cancer Committee, “Staging Announcements,” Gynecologic Oncology, Vol. 25, No. 3, 1986, pp. 383-385. doi:10.1016/0090-8258(86)90092-2
[5] P. B. Panici, G. Scambia, G. Baiocchi, et al., “Anatomical Study of Para-Aortic and Pelvic Lymph-Nodes in Gynecologic Malignancies,” Obstetrics & Gynecology, Vol. 79, No. 4, 1992, pp. 498-502.
[6] G. Ferraris, A. Lanza, F. D’Addato, et al., “Techniques of Pelvic and Para-Aortic Lymphadenectomy in the Surgical Treatment of Cervix Carcinoma,” European Journal of Gynecologic Oncology, Vol. 9, 1998, pp. 83-86.
[7] P. B. Panici, G. Scambia, G. Baiocchi, et al., “Technique and Feasibility of Systematic Paraaortic and Pelvic Lymphadenectomy in Gynecologic Malignancies, A Prospective Study,” International Journal of Gynecological Cancer, Vol. 1, No. 3, 1991, pp. 133-140. doi:10.1111/j.1525-1438.1991.tb00028.x
[8] C. T. Griffiths, “Surgical Resection of Tumor Bulk in the Primary Treatment of Ovarian Carcinoma,” The Journal of the National Cancer Institute, Vol. 42, 1975, pp. 101-104.
[9] N. F. Hacker, J. S. Berek, L. D. Lagasse, et al., “Primary Cytoreductive Surgery for Epithelial Ovarian Cancer,” Obstetrics & Gynecology, Vol. 61, No. 4, 1983, pp. 413-420
[10] E. L. Kaplan and P. Meier, “Non Parametric Estimation from Incomplete Observations,” Journal of the American Statistical Association, Vol. 53, No. 282, 1958, pp. 457-481. doi:10.1080/0162 1459.1958.10501452
[11] R. Peto, M. C. Pike, P. Armitage, et al., “Design and Analysis of Randomized Clinical Trials Requiring Prolonged Observation of Each Patient. II. Analysis and Example,” British Journal of Cancer, Vol. 35, No. 1, 1977, pp. 1-39. doi:10.1038/bjc.1977.1
[12] P. J. Di Saia and W. T. Creasman, “Clinical Gynecologic Oncology,” 6th Edition, Mosby, St. Louis, 2002.
[13] ASTEC Study Group, H. Kitchener, A. M. Swart, Q. Qian, et al., “Efficacy of Systematic Pelvic Lymphadenectomy in Endometrial Cancer (MRC ASTECtrial): A Randomized Study,” Lancet, Vol. 373, No. 9658, 2009, pp. 125-136.
[14] P. B. Panici, A. Maggioni, N. Hacker, et al., “Systematic Aortic and Pelvic Lymphadenectomy versus Resection of Bulky Nodes only in Optimally Debulked Advanced Ovarian Cancer: A Randomized Clinical Trial,” The Journal of the National Cancer Institute, Vol. 97, No. 8, 2005, pp. 560-566. doi:10.1093/jnci/dji102
[15] R. E. Bristow, R. S. Tomacruz, D. K. Armstrong, et al., “Survival Effect of Maximal Cytoreductive Surgery for Advanced Ovarian Carcinoma during Platinum Era: A Meta-Analysis,” Journal of Clinical Oncology, Vol. 20, No. 5, 2002, pp. 1248-1259. doi:10.1200/JCO.20.5.1248
[16] T. Onda, H. Yoshikawa, H. Yokota, et al., “Assessment of Metastases to Aortic and Pelvic Lymph Nodes in Epithelial Ovarian Carcinoma. A Proposal for Essential Sites for Lymph Node Biopsy,” Cancer, Vol. 78, No. 4, 1996, pp. 803-808. doi:10.1002/(SICI)1097-0142(19960815)78:4<803::AID-CNCR17>3.0.CO;2-Z

comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.