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Role of systematic pelvic and para-aortic lymphadenectomy in delayed debulking surgery after six neoadjuvant chemotherapy cycles for high-grade serous ovarian carcinoma.
Lopes, Andre; Genta, Maria L N D; da Costa Miranda, Vanessa; Aranha, Andrea; Lopez, Rossana V M; Piato, Dariane S A M; Anton, Cristina; Carvalho, Filomena M; Del Pilar Esteves Diz, Maria; Carvalho, Jesus P.
Afiliação
  • Lopes A; Discipline of Gynecology, Department of Obstetrics and Gynecology, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Genta MLND; Gastroenterology Department, Digestive Surgery Division, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • da Costa Miranda V; Discipline of Gynecology, Department of Obstetrics and Gynecology, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Aranha A; Department of Radiology and Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Lopez RVM; Department of Radiology and Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Piato DSAM; Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Anton C; Discipline of Gynecology, Department of Obstetrics and Gynecology, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Carvalho FM; Discipline of Gynecology, Department of Obstetrics and Gynecology, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Del Pilar Esteves Diz M; Department of Pathology, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Carvalho JP; Department of Radiology and Oncology, Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
J Obstet Gynaecol Res ; 47(8): 2737-2744, 2021 Aug.
Article em En | MEDLINE | ID: mdl-33998104
INTRODUCTION: We analyzed the role of systematic pelvic and para-aortic lymphadenectomy in delayed debulking surgery after six neoadjuvant chemotherapy (NACT) cycles for advanced high-grade serous ovarian carcinoma. MATERIALS AND METHODS: We retrospectively reviewed patients with advanced ovarian carcinoma who underwent NACT with carboplatin-paclitaxel between 2008 and 2016. Patients were included only if they had FIGO IIIC-IVB high-grade serous carcinoma with clinically negative lymph nodes after six NACT cycles (carboplatin-paclitaxel) and underwent complete or near complete cytoreduction. Patients with partial lymphadenectomy or bulky nodes were excluded. Patients who underwent systematic pelvic and aortic lymphadenectomy and those who did not undergo lymph node dissection were compared. Progression-free and overall survivals were analyzed using the Kaplan-Meier method. RESULTS: Totally, 132 patients with FIGO IIIC-IVB epithelial ovarian carcinoma were surgically treated after NACT. Sixty patients were included (39 and 21 in the lymphadenectomy and nonlymphadenectomy group, respectively); 40% had suspicious lymph nodes before NACT. Patient characteristics, blood transfusion numbers, and complication incidence were similar between the groups. In the lymphadenectomy group, 12 patients (30.8%) had histologically positive lymph nodes and the surgical time was longer (229 vs. 164 min). The median overall survival in the lymphadenectomy and nonlymphadenectomy groups, respectively, was 56.7 (95% CI 43.4-70.1) and 61.2 (21.4-101.0) months (p = 0.934); the corresponding disease-free survival was 8.1 (6.2-10.1) and 8.3 (5.1-11.6) months (p = 0.878). Six patients exclusively presented with lymph node recurrence. CONCLUSIONS: Systematic lymphadenectomy after six NACT cycles may have no influence on survival.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Ovarianas / Terapia Neoadjuvante Tipo de estudo: Observational_studies Limite: Female / Humans Idioma: En Revista: J Obstet Gynaecol Res Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Austrália
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Ovarianas / Terapia Neoadjuvante Tipo de estudo: Observational_studies Limite: Female / Humans Idioma: En Revista: J Obstet Gynaecol Res Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Austrália