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Does complete-staging lymphadenectomy improve survival outcomes in stage I endometrioid epithelial ovarian carcinoma? A multi-institutional retrospective study with propensity score-weighted analysis

Yoshihara, Masato ; Tamauchi, Satoshi ; Iyoshi, Shohei ; Kitami, Kazuhisa ; Uno, Kaname LU orcid ; Tano, Sho ; Matsui, Shigeyuki and Kajiyama, Hiroaki (2021) In Japanese journal of clinical oncology 51(3). p.387-392
Abstract

BACKGROUND: We investigated the prognostic impact of complete-staging lymphadenectomy on patients with clinically apparent Stage I endometrioid epithelial ovarian carcinoma. METHODS: We conducted a regional multi-institutional retrospective study between 1986 and 2018. Amongst 4897 patients with malignant ovarian tumours diagnosed under central pathological review, 259 women with Stage I endometrioid epithelial ovarian carcinoma were eligible. We evaluated differences in survival of patients with both pelvic and para-aortic lymphadenectomy (Group A) and those with only pelvic lymphadenectomy and/or clinical lymph node evaluation (Group B). To analyse the therapeutic effects, the baseline imbalance between patients with both pelvic and... (More)

BACKGROUND: We investigated the prognostic impact of complete-staging lymphadenectomy on patients with clinically apparent Stage I endometrioid epithelial ovarian carcinoma. METHODS: We conducted a regional multi-institutional retrospective study between 1986 and 2018. Amongst 4897 patients with malignant ovarian tumours diagnosed under central pathological review, 259 women with Stage I endometrioid epithelial ovarian carcinoma were eligible. We evaluated differences in survival of patients with both pelvic and para-aortic lymphadenectomy (Group A) and those with only pelvic lymphadenectomy and/or clinical lymph node evaluation (Group B). To analyse the therapeutic effects, the baseline imbalance between patients with both pelvic and para-aortic lymphadenectomy and others was adjusted with an inverse probability of treatment weighting using propensity score involving independent clinical variables. RESULTS: In total, 145 patients (56.0%) received both pelvic and para-aortic lymphadenectomy. With propensity score-based adjustment, estimated survival was better in Group A compared with that in Group B but not significant. Pelvic and para-aortic lymphadenectomy also led to no significant improvement of overall survival in most of the subgroups. However, point estimations of the hazard ratio for lymphadenectomy in patients with an age of 45 or younger (hazard ratio, 0.304; 95% confidence interval, 0.094-0.982), a Grade 1-2 (hazard ratio, 0.441; 95% confidence interval, 0.204-0.954) and T1c2-3 tumour (hazard ratio, 0.449; 95% confidence interval, 0.164-1.231) were better compared with those with the opposite characteristics. CONCLUSIONS: Complete-staging lymphadenectomy was not a significant prognostic factor in patients with Stage I endometrioid epithelial ovarian carcinoma, where we still need to explore appropriate candidate for the procedure.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
carcinoma, endometrioid, epithelial ovarian carcinoma, lymph node excision, prognosis
in
Japanese journal of clinical oncology
volume
51
issue
3
pages
6 pages
publisher
Oxford University Press
external identifiers
  • scopus:85102658057
  • pmid:33253382
ISSN
1465-3621
DOI
10.1093/jjco/hyaa206
language
English
LU publication?
yes
id
4acc0bbe-ef31-4e7d-8696-d310551f00c2
date added to LUP
2021-03-24 12:36:42
date last changed
2024-04-20 03:23:23
@article{4acc0bbe-ef31-4e7d-8696-d310551f00c2,
  abstract     = {{<p>BACKGROUND: We investigated the prognostic impact of complete-staging lymphadenectomy on patients with clinically apparent Stage I endometrioid epithelial ovarian carcinoma. METHODS: We conducted a regional multi-institutional retrospective study between 1986 and 2018. Amongst 4897 patients with malignant ovarian tumours diagnosed under central pathological review, 259 women with Stage I endometrioid epithelial ovarian carcinoma were eligible. We evaluated differences in survival of patients with both pelvic and para-aortic lymphadenectomy (Group A) and those with only pelvic lymphadenectomy and/or clinical lymph node evaluation (Group B). To analyse the therapeutic effects, the baseline imbalance between patients with both pelvic and para-aortic lymphadenectomy and others was adjusted with an inverse probability of treatment weighting using propensity score involving independent clinical variables. RESULTS: In total, 145 patients (56.0%) received both pelvic and para-aortic lymphadenectomy. With propensity score-based adjustment, estimated survival was better in Group A compared with that in Group B but not significant. Pelvic and para-aortic lymphadenectomy also led to no significant improvement of overall survival in most of the subgroups. However, point estimations of the hazard ratio for lymphadenectomy in patients with an age of 45 or younger (hazard ratio, 0.304; 95% confidence interval, 0.094-0.982), a Grade 1-2 (hazard ratio, 0.441; 95% confidence interval, 0.204-0.954) and T1c2-3 tumour (hazard ratio, 0.449; 95% confidence interval, 0.164-1.231) were better compared with those with the opposite characteristics. CONCLUSIONS: Complete-staging lymphadenectomy was not a significant prognostic factor in patients with Stage I endometrioid epithelial ovarian carcinoma, where we still need to explore appropriate candidate for the procedure.</p>}},
  author       = {{Yoshihara, Masato and Tamauchi, Satoshi and Iyoshi, Shohei and Kitami, Kazuhisa and Uno, Kaname and Tano, Sho and Matsui, Shigeyuki and Kajiyama, Hiroaki}},
  issn         = {{1465-3621}},
  keywords     = {{carcinoma, endometrioid; epithelial ovarian carcinoma; lymph node excision; prognosis}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{387--392}},
  publisher    = {{Oxford University Press}},
  series       = {{Japanese journal of clinical oncology}},
  title        = {{Does complete-staging lymphadenectomy improve survival outcomes in stage I endometrioid epithelial ovarian carcinoma? A multi-institutional retrospective study with propensity score-weighted analysis}},
  url          = {{http://dx.doi.org/10.1093/jjco/hyaa206}},
  doi          = {{10.1093/jjco/hyaa206}},
  volume       = {{51}},
  year         = {{2021}},
}