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Mesenteric Lymph Node Involvement in Advanced Ovarian Cancer Patients Undergoing Rectosigmoid Resection: Prognostic Role and Clinical Considerations

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The aim of this retrospective study was to investigate the incidence of mesenteric lymph node (MLN) involvement, and its prognostic role in advanced ovarian cancer (OC).

Methods

OC patients undergoing rectosigmoid resection during primary debulking surgery or interval debulking surgery were recorded. Progression-free survival (PFS) and overall survival were calculated from the date of diagnosis to the date of relapse/progression, death of disease, or the date of last follow-up.

Results

MLNs were detected in 102/148 cases (68.9 %); the rate of MLN involvement was 47.0 %. The percentage of metastatic MLNs was higher in cases with >5 MLNs removed compared with cases with ≤5 MLNs removed (62.7 % vs. 31.3 %; p = 0.0027). A progressive increase in the rate of metastatic MLNs was documented in association with depth of bowel infiltration (p = 0.026). Cases with metastatic MLNs experienced isolated celiac trunk or aortic lymph node recurrences more frequently than patients without MLN involvement (44.8 % vs. 10.7 %; p = 0.0008). PFS did not differ between cases with positive versus negative MLN involvement (2-year PFS = 31 % vs. 43 %; p = 0.58).

Conclusion

OC patients undergoing rectosigmoid resection showed metastatic MLN involvement in 47.0 % of cases. Metastatic MLN status is associated with a high rate of isolated aortic and celiac trunk lymph node recurrences.

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Conflict of interest

The Authors declare they have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Gynecologic Oncology Unit, Catholic University, Rome, Italy

    Valerio Gallotta, Salvatore Gueli Alletti, Camilla Nero, Alessandro Pasquale Margariti, Francesca Ciccarone, Giovanni Scambia & Gabriella Ferrandina MD

  2. Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy

    Francesco Fanfani

  3. Gynecologic Surgery, University of Perugia, Terni, Italy

    Anna Fagotti

  4. Gynecologic Oncology Unit, “Giovanni Paolo II” Foundation, Campobasso, Italy

    Vito Chiantera & Francesco Legge

  5. Department of Surgery, Catholic University, Rome, Italy

    Valerio Papa & Sergio Alfieri

  6. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy

    Gabriella Ferrandina MD

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  1. Valerio Gallotta
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  2. Francesco Fanfani
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  3. Anna Fagotti
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  4. Vito Chiantera
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  8. Alessandro Pasquale Margariti
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  13. Gabriella Ferrandina MD
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Correspondence to Gabriella Ferrandina MD.

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Gallotta, V., Fanfani, F., Fagotti, A. et al. Mesenteric Lymph Node Involvement in Advanced Ovarian Cancer Patients Undergoing Rectosigmoid Resection: Prognostic Role and Clinical Considerations. Ann Surg Oncol 21, 2369–2375 (2014). https://doi.org/10.1245/s10434-014-3558-0

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  • DOI: https://doi.org/10.1245/s10434-014-3558-0

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