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The efficacy of systematic lymph node dissection in advanced epithelial ovarian cancer during interval debulking surgery performed after neoadjuvant chemotherapy

 Kyung Jin Eoh  ;  Jung Won Yoon  ;  Inok Lee  ;  Jung‐Yun Lee  ;  Sunghoon Kim  ;  Sang Wun Kim  ;  Young Tae Kim  ;  Eun Ji Nam 
 JOURNAL OF SURGICAL ONCOLOGY, Vol.116(3) : 329-336, 2017 
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Issue Date
Adult ; Aged ; Antineoplastic Agents/therapeutic use* ; Chemotherapy, Adjuvant ; Cytoreduction Surgical Procedures* ; Disease-Free Survival ; Female ; Humans ; Lymph Node Excision* ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Neoplasms, Glandular and Epithelial/mortality ; Neoplasms, Glandular and Epithelial/pathology ; Neoplasms, Glandular and Epithelial/therapy* ; Ovarian Neoplasms/mortality ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/therapy* ; Retrospective Studies ; Survival Rate ; Treatment Outcome
advanced epithelial ovarian cancer ; interval debulking surgery ; lymphadenectomy ; optimal cytoreductive surgery
BACKGROUND AND OBJECTIVE: The therapeutic role of systematic lymph node dissection (LND) remains unclear in advanced epithelial ovarian cancer (EOC), especially during interval debulking surgery (IDS) performed after neoadjuvant chemotherapy (NAC). We analyzed the therapeutic and prognostic roles of systematic LND in advanced EOC patients. METHODS: Data from consecutive patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC-IV disease, who underwent optimal IDS (<1cm) after NAC, were obtained via a retrospective chart review. Patients were classified into a lymph node sampling (LNS; node count <20) group and an LND (node count ≥20) group. RESULTS: Among 133 study patients, 65 and 68 underwent LND and LNS, respectively, during IDS. Overall survival (OS) was significantly better in the LND group than in the LNS group. In subgroup analysis with negative lymphadenopathy on preoperative imaging, progression-free survival (PFS) and OS were significantly better in the LND group than in the LNS group. Follow-up of subsequent recurrences showed significantly lower nodal and peritoneal recurrence rates among patients who underwent LND. Multivariate analysis identified LND as an independent prognostic factor for PFS and OS. CONCLUSION: Systematic LND may have therapeutic value in advanced EOC patients treated with NAC and IDS.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Wun(김상운) ORCID logo https://orcid.org/0000-0002-8342-8701
Kim, Sung Hoon(김성훈) ORCID logo https://orcid.org/0000-0002-1645-7473
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Nam, Eun Ji(남은지)
Eoh, Kyung Jin(어경진) ORCID logo https://orcid.org/0000-0002-1684-2267
Lee, In Ok(이인옥)
Lee, Jung-Yun(이정윤) ORCID logo https://orcid.org/0000-0001-7948-1350
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