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Prognostic significance of supradiaphragmatic lymph node metastasis detected by 18F-FDG PET/CT in advanced epithelial ovarian cancer

 In Ok Lee  ;  Jung-Yun Lee  ;  Hyun Jeong Kim  ;  Eun Ji Nam  ;  Sunghoon Kim  ;  Sang Wun Kim  ;  Chang Young Lee  ;  Won Jun Kang  ;  Young Tae Kim 
 BMC Cancer, Vol.18(1) : 1165, 2018 
Journal Title
 BMC Cancer 
Issue Date
Ovarian cancer ; Ovarian neoplasm ; PET/CT ; Recurrence pattern ; Supradiaphragmatic lymph node ; Survival
BACKGROUND: Supradiaphragmatic lymph node metastases (SdLNM) are frequently identified using 18F-FDG positron emission tomography/computed tomography (PET/CT) in advanced epithelial ovarian cancers (AEOC). This study aimed to determine the prognostic significance of SdLNM detected by PET/CT in patients with AEOC. METHODS: Medical records of patients diagnosed with AEOC were retrospectively registered from January 2009 to July 2015. Patients were categorized according to PET/CT stage: PET/CT stage III, PET/CT stage IV with SdLNM, and PET/CT stage IV with other metastases. Clinicopathologic characteristics, recurrence patterns, survival outcomes were compared according to PET/CT stage. Anatomical distribution of SdLNM and effect of thoracic debulking surgery were estimated. RESULTS: A total of 295 patients were identified, including 176 patients who underwent primary debulking surgeries (PDS). Progression-free (P = 0.671) and overall (P = 0.525) survival did not differ significantly between patients with PET/CT IV with SdLNM and PET/CT IV with other metastases; however, patients with PET/CT IV with SdLNM had significantly poorer progression-free (P < 0.001) and overall (P = 0.016) survival than those with PET/CT stage III. Recurrence patterns were similar in all groups; intraperitoneal metastasis was the most common (78.8%) and thoracic recurrence alone accounted for less than 10%. Debulking of SdLNM lesions did not improve progression-free survival (P = 0.425) or overall survival (P = 0.465) of patients with AEOC. CONCLUSIONS: SdLNM detected using preoperative PET/CT are a negative prognostic factor in AEOC. Resection of suspicious SdLNM may not have effect to survival of patients with AEOC.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
강원준(Kang, Won Jun) ORCID logo https://orcid.org/0000-0002-2107-8160
김상운(Kim, Sang Wun) ORCID logo https://orcid.org/0000-0002-8342-8701
김성훈(Kim, Sung Hoon) ORCID logo https://orcid.org/0000-0002-1645-7473
김영태(Kim, Young Tae) ORCID logo https://orcid.org/0000-0002-7347-1052
김현정(Kim, Hyun Jeong) ORCID logo https://orcid.org/0000-0002-3116-8848
남은지(Nam, Eun Ji)
이인옥(Lee, In Ok)
이정윤(Lee, Jung-Yun) ORCID logo https://orcid.org/0000-0001-7948-1350
이창영(Lee, Chang Young)
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