Impact of lymph node ratio on survival in stage III ovarian high-grade serous cancer: a Turkish Gynecologic Oncology Group study
- Author:
Ali AYHAN
1
;
Nazlı Topfedaisi OZKAN
;
Mustafa Erkan SARI
;
Husnu CELIK
;
Murat DEDE
;
Ozgür AKBAYIR
;
Kemal GÜNGÖRDÜK
;
Hanifi ŞAHIN
;
Ali HABERAL
;
Tayfun GÜNGÖR
;
Macit ARVAS
;
Mehmet Mutlu MEYDANLI
Author Information
- Publication Type:Multicenter Study
- Keywords: Analysis, Survival; Epithelial Ovarian Cancer; Lymph Node; Serous Cystadenecarcinom
- MeSH: Carboplatin; Cohort Studies; Diagnosis; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Lymph Node Excision; Lymph Nodes; Methods; Multivariate Analysis; Paclitaxel; Proportional Hazards Models; Retrospective Studies; Survival Analysis; Turkey
- From:Journal of Gynecologic Oncology 2018;29(1):e12-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: The purpose of this study was to investigate the prognostic value of lymph node ratio (LNR) in patients with stage III ovarian high-grade serous carcinoma (HGSC). METHODS: A multicenter, retrospective department database review was performed to identify patients with ovarian HGSC at 6 gynecologic oncology centers in Turkey. A total of 229 node-positive women with stage III ovarian HGSC who had undergone maximal or optimal cytoreductive surgery plus systematic lymphadenectomy followed by paclitaxel plus carboplatin combination chemotherapy were included. LNR, defined as the percentage of positive lymph nodes (LNs) to total nodes recovered, was stratified into 3 groups: LNR1 (<10%), LNR2 (10%≤LNR<50%), and LNR3 (≥50%). Kaplan-Meier method was used to generate survival data. Factors predictive of outcome were analyzed using Cox proportional hazards models. RESULTS: Thirty-one women (13.6%) were classified as stage IIIA1, 15 (6.6%) as stage IIIB, and 183 (79.9%) as stage IIIC. The median age at diagnosis was 56 (range, 18–87), and the median duration of follow-up was 36 months (range, 1–120 months). For the entire cohort, the 5-year overall survival (OS) was 52.8%. An increased LNR was associated with a decrease in 5-year OS from 65.1% for LNR1, 42.5% for LNR2, and 25.6% for LNR3, respectively (p<0.001). In multivariate analysis, women with LNR≥0.50 were 2.7 times more likely to die of their tumors (hazard ratio [HR]=2.7; 95% confidence interval [CI]=1.42–5.18; p<0.001). CONCLUSION: LNR seems to be an independent prognostic factor for decreased OS in stage III ovarian HGSC patients.
