title: Nodal status--its impact on prognosis in advanced ovarian cancer.
abstract: OBJECTIVE
  Prognostic impact of nodal status or lymphadenectomy in advanced ovarian cancer is still unclear. Known best prognostic impact in advanced ovarian cancer has the residual tumor mass. The aim of this retrospective study is to examine the importance of nodal status in correlation with residual tumor mass.
  
  
  METHODS
  One hundred and fifty-seven consecutive patients with primary stage III ovarian cancer underwent surgery between 01/2000 and 06/2007 at the Department of gynecology and obstetrics, University Hospital, Tübingen, Germany. All patients got stage-related surgery and platin-based chemotherapy. Median follow-up time was 53.5 months, and all patients were included in the study.
  
  
  RESULTS
  Resection status and nodal status are significant prognostic factors in our study (P < 0.001). In FIGO III, patients without residual tumor (R0) had significant best OS and PFS independent to node status (N0/N+; P = 0.002) compared to patients with residual tumor. In contrast, node status had significant positive impact on PFS in patients without residual tumor and node negativity. With the increase in residual tumor, the influence of lymphnode metastases on prognosis is decreasing.
  
  
  CONCLUSIONS
  Main intention of primary surgery is R0 resection with best prognosis in advanced stages. A systematic lymphadenectomy in cases with R0 resection or residual tumor <1 cm seems to be reasonable with positive impact on prognosis. Node status has impact on prognosis in patients with negative node after R0 resection with best PFS in FIGO III. Further prospective studies had to show whether systematic lymphadenectomy in suboptimally tumor-reduced patients can improve prognosis.
authors: Department of Gynecology and Obstetrics, University of Tübingen, Calwer Str. 7, 72070, Tübingen, Germany. cornelia.bachmann@med.uni-tuebingen.de
authors: C
authors: C
authors: Bachmann
authors: S
authors: S
authors: Bachmann
authors: T
authors: T
authors: Fehm
authors: A
authors: A
authors: Staebler
authors: S
authors: S
authors: Becker
authors: R
authors: R
authors: Rothmund
authors: C
authors: C
authors: Gardanis
authors: E M
authors: EM
authors: Grischke
authors: D
authors: D
authors: Wallwiener
authors: E F
authors: EF
authors: Solomayer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis