title: Prevalence of lymph node metastasis and prognostic significance of lymphadenectomy in apparent early-stage malignant ovarian sex cord-stromal tumors.
abstract: The aim of this retrospective population-based study was to investigate the prevalence of lymph node metastasis in patients with apparent early stage malignant sex cord-stromal tumors (SCSTs) and the effect of regional lymph node sampling/lymphadenectomy (LND) on their survival.
  
  
  
  A cohort of patients diagnosed with malignant SCSTs between 1988 and 2012 was drawn from the National Cancer Institute's Surveillance, Epidemiology, and End Results database. Overall and Cancer Specific Survival, stratified by performance of LND, were calculated following generation of Kaplan-Meier curves. Comparisons were made using the log-rank and Breslow tests. A multivariate Cox proportional analysis was performed to determine the effect of LND on overall mortality.
  
  
  
  A total of 1156 patients with SCST met the inclusion criteria; 1000 (86.5%) and 156 (13.5%) patients had apparent stage I and II disease, respectively. LND was performed in 572 (49.5%) patients. Lymph node metastases were pathologically confirmed in 19 patients (3.3%). Five-year cancer specific survival (CSS) was similar, 92.7% and 94.7%, for patients who did or did not undergo LND, respectively. According to multivariate analysis overall mortality did not differ between the two groups after controlling for age, histology and apparent stage.
  
  
  
  Regional lymphatic mode metastasis in patients with apparent early stage SCSTs is uncommon and lymphadenectomy did not confer a survival benefit in this cohort.
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA. Electronic address: din2004@med.cornell.edu.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Nasioudis
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
authors.forename: Tomi T
authors.initials: TT
authors.lastname: Kanninen
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Holcomb
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sisti
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Witkin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D018426:SEER Program; D018312:Sex Cord-Gonadal Stromal Tumors / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Granulosa cell; Lymphadenectomy; Ovarian cancer; Sex cord-stromal tumors