Is there any association between retroperitoneal lymphadenectomy and survival benefit in ovarian clear cell carcinoma patients?
BACKGROUND
To estimate the survival impact of systemic retroperitoneal lymphadenectomy in patients diagnosed with International Federation of Gynecology and Obstetrics pTI-IIb clear cell carcinoma of the ovary (CCC).


METHODS
Demographic and clinicopathologic data were obtained from the Tokai Ovarian Tumor Study Group between 1986 and 2006. Survival curves were calculated using the Kaplan-Meier method. Differences in survival rates were analyzed using the log-rank test.


RESULTS
A total of 205 patients had clinical pTI-IIb CCC (median age: 52 years, range: 30-75). One hundred and four (50.7%) patients underwent systemic retroperitoneal lymphadenectomy. Lymphadenectomy was not associated with improved disease-free and overall survival in all patients (P = 0.353 and P = 0.645, respectively). Moreover, lymphadenectomy did not improve the overall survival in those with pTIc CCC (P = 0.433). Similarly, on univariate analysis, age, volume of ascites, preoperative CA 125 values, and regimen of chemotherapy were not significant factors. In addition, there was no significant difference in the ratio of positive lymph node metastases regardless of the completion of lymphadenectomy (P = 0.955).


CONCLUSIONS
Our data suggest that patients with pTI-IIb CCC who underwent lymphadenectomy did not show a significant improvement in survival. There was no significant difference in the overall and disease-free survival rates in pTI-IIb CCC patients regardless of the completion of surgical staging lymphadenectomy.
Suzuki
S
S
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Kajiyama
H
H
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: kajiyama@med.nagoya-u.ac.jp.
Shibata
K
K
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Ino
K
K
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nawa
A
A
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Sakakibara
K
K
Department of Obstetrics and Gynecology, Okazaki City Hospital, Okazaki.
Matsuzawa
K
K
Department of Obstetrics and Gynecology, Anjyo Kosei Hospital, Anjyo.
Takeda
A
A
Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi.
Kinoshita
Y
Y
Department of Obstetrics and Gynecology, Ogaki Municipal Hospital, Ogaki.
Kawai
M
M
Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital, Toyohashi.
Nagasaka
T
T
Division of Pathology, Clinical Laboratory, Nagoya University Hospital, Nagoya, Japan.
Kikkawa
F
F
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
D018262:Adenocarcinoma, Clear Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D012187:Retroperitoneal Space / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome