The Therapeutic Impact of Lymphadenectomy in the Management of Epithelial Ovarian Cancer: A Single Institution Experience

Abstract

Aim: To assess the impact of lymphadenectomy on overall survival (OS) and progression-free survival (PFS) in patients with epithelial ovarian cancer (EOC). Study Design: Retrospective observational study. Place and Duration of Study: All patients diagnosed with epithelial ovarian, fallopian tube or primary peritoneal cancer treated in the Department of Gynecologic Oncology in a tertiary care hospital in South India from January 2012 onwards. All patients’ follow up data was prospectively updated till 30 April 2017. Methodology: We included 83 patients who met the inclusion criteria. The patients were classified into two groups based on the number of lymph nodes (LN) harvested (< 30 lymph nodes and > 30 nodes). Lymphadenectomy was considered systematic (SLND) when the harvest was > 30 nodes on the pathologic specimen. Results: Out of the 83 cases, complete SLND was done in 43 (51.8%) cases and the median number of removed lymph nodes was 44 (IQR 25– 75%: 38–52). Among the women who underwent a complete SLND, the median OS was 55.7 months vs 49.0 months among those where the lymph node harvest count was < 30 (P value – 0.16). The median PFS in the complete SLND group was 49.0 months and 43.46 months for the other group with no significant difference (P value – 0.18). Though there was no significant difference in OS and PFS, there was a trend towards improved survival with complete SLND group beyond 500 days. Conclusion: Complete SLND group showed a trend towards improved OS and PFS, though statistically not significant. Further investigation is warranted.