Factors associated with the involvement of lymph nodes in low‐grade serous ovarian cancer
Abstract
Background and Objectives
Evaluating nodal metastases in low‐grade serous ovarian cancer (LGSOC) patients.
Methods
Women with LGSOC who had undergone primary cytoreductive surgery comprising systematic pelvic‐paraaortic lymphadenectomy were included. Data were obtained retrospectively from 12 oncology centers.
Results
One hundred and forty‐eight women with LGSOC who had undergone comprehensive surgical staging were included. Seventy‐one (48.0%) patients had metastatic lymph nodes. Preoperative serum CA‐125 levels of ≥170 U/ml (odds ratio [OR]: 3.84; 95% confidence interval [CI]: 1.22–12.07; p = 0.021) and presence of lymphovascular space invasion (LVSI) (OR: 13.72; 95% CI: 3.36–55.93; p < 0.001) were independent predictors of nodal metastasis in LGSOC. Sixty (40.5%) patients were classified to have apparently limited disease to the ovary/ovaries. Twenty (33.3%) of them were upstaged after surgical staging. Twelve (20.0%) had metastatic lymph nodes. Presence of LVSI (OR: 12.96; 95% CI: 1.14–146.43; p = 0.038) and preoperative serum CA‐125 of ≥180 U/ml (OR: 7.19; 95% CI: 1.35–38.12; p = 0.02) were independent predictors of lymph node metastases in apparent Stage Ⅰ disease.
Conclusions
Clinicians may consider to perform a reoperation comprising systematic lymphadenectomy in patients who had apparently limited disease to the ovary/ovaries and had not undergone lymphadenectomy initially. Reoperation may be considered particularly in patients whose preoperative serum CA‐125 is ≥180 U/ml and/or whose pathological assessment reported the presence of LVSI.