title: Risk factors for lymph node metastasis in ovarian cancer: Implications for systematic lymphadenectomy.
abstract: BACKGROUND
  The purpose of this study was to assess the risk factors associated with lymph node metastases and to evaluate the role of systematic lymphadenectomy in ovarian cancer.
  
  
  METHODS
  We retrospectively reviewed patients diagnosed with ovarian cancer between December 2004 and March 2012. Demographics, pathologic findings, and correlations with lymph node metastases were assessed.
  
  
  RESULTS
  A total of 256 patients were identified. The mean number of removed lymph nodes was 20.5 (range, 2-57), and 84 patients (32.8%) had nodal metastases. The mean number of positive lymph nodes was 3 (range, 1-40) in patients with lymph node metastases. Univariate analysis showed that serous histology, histological grade 2-3, and CA-125 level at diagnosis >740 U/mL were significant risk factors for lymph node metastases. Multivariate analysis showed that serous histology (odds ratio [OR], 2.728; 95% confidence interval [CI], 1.072-6.945; p = 0.035), histological grade 2-3 (OR 1.897; 95% CI, 1.209-2.977; p = 0.005), and CA-125 level at diagnosis >740 U/mL (OR, 3.858; 95% CI 2.143-6.947; p < 0.001) remain the most important risk factors for lymph node metastases. The nodal metastasis rates for 0 to 1 risk factors were significantly lower than those of 2-3 risk factors (3.7% vs. 40.6%; p < 0.001).
  
  
  CONCLUSIONS
  The current study suggests that the decision making of systematic lymphadenectomy in ovarian cancer patients should be referred to the histological type, grade, and CA-125 level at diagnosis.
authors.affiliation: Xiamen Cancer Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, PR China.
authors.forename: Juan
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Sun Yat-sen University Cancer Center, Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, PR China.
authors.forename: Jia-Yuan
authors.initials: JY
authors.lastname: Sun
authors.affiliation: Xiamen Cancer Center, Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, PR China.
authors.forename: San-Gang
authors.initials: SG
authors.lastname: Wu
authors.affiliation: Department of Basic Medical Science, Medical College, Xiamen University, Xiamen, PR China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Wang
authors.affiliation: Sun Yat-sen University Cancer Center, Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, PR China.
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: He
authors.affiliation: Xiamen Cancer Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, PR China. Electronic address: cqhua616@126.com.
authors.forename: Qiong-Hua
authors.initials: QH
authors.lastname: Chen
authors.affiliation: Sun Yat-sen University Cancer Center, Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, PR China. Electronic address: lify@sysucc.org.cn.
authors.forename: Feng-Yan
authors.initials: FY
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data*; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D010051:Ovarian Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D018394:CA-125 Antigen
keywords: CA-125; Histology type; Lymph node metastases; Lymphadenectomy; Ovarian cancer