title: Mesenteric lymph node involvement in advanced ovarian cancer patients undergoing rectosigmoid resection: prognostic role and clinical considerations.
abstract: BACKGROUND
  The aim of this retrospective study was to investigate the incidence of mesenteric lymph node (MLN) involvement, and its prognostic role in advanced ovarian cancer (OC).
  
  
  METHODS
  OC patients undergoing rectosigmoid resection during primary debulking surgery or interval debulking surgery were recorded. Progression-free survival (PFS) and overall survival were calculated from the date of diagnosis to the date of relapse/progression, death of disease, or the date of last follow-up.
  
  
  RESULTS
  MLNs were detected in 102/148 cases (68.9 %); the rate of MLN involvement was 47.0 %. The percentage of metastatic MLNs was higher in cases with >5 MLNs removed compared with cases with ≤ 5 MLNs removed (62.7 % vs. 31.3 %; p = 0.0027). A progressive increase in the rate of metastatic MLNs was documented in association with depth of bowel infiltration (p = 0.026). Cases with metastatic MLNs experienced isolated celiac trunk or aortic lymph node recurrences more frequently than patients without MLN involvement (44.8 % vs. 10.7 %; p = 0.0008). PFS did not differ between cases with positive versus negative MLN involvement (2-year PFS = 31 % vs. 43 %; p = 0.58).
  
  
  CONCLUSIONS
  OC patients undergoing rectosigmoid resection showed metastatic MLN involvement in 47.0 % of cases. Metastatic MLN status is associated with a high rate of isolated aortic and celiac trunk lymph node recurrences.
authors.affiliation: Gynecologic Oncology Unit, Catholic University, Rome, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Gallotta
authors.forename: Francesco
authors.initials: F
authors.lastname: Fanfani
authors.forename: Anna
authors.initials: A
authors.lastname: Fagotti
authors.forename: Vito
authors.initials: V
authors.lastname: Chiantera
authors.forename: Francesco
authors.initials: F
authors.lastname: Legge
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gueli Alletti
authors.forename: Camilla
authors.initials: C
authors.lastname: Nero
authors.forename: Alessandro Pasquale
authors.initials: AP
authors.lastname: Margariti
authors.forename: Valerio
authors.initials: V
authors.lastname: Papa
authors.forename: Sergio
authors.initials: S
authors.lastname: Alfieri
authors.forename: Francesca
authors.initials: F
authors.lastname: Ciccarone
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
authors.forename: Gabriella
authors.initials: G
authors.lastname: Ferrandina
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018284:Cystadenocarcinoma, Serous / Q000401:mortality / Q000556:secondary / Q000601:surgery; D016889:Endometrial Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008643:Mesentery / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D060787:Neoplasm Grading; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012007:Rectum / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012811:Sigmoid Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D015996:Survival Rate