J Gynecol Oncol.
2018 Jan;29(1):e12. 10.3802/jgo.2018.29.e12.
Impact of lymph node ratio on survival in stage III ovarian high-grade serous cancer: a Turkish Gynecologic Oncology Group study
- Ayhan A
- Ozkan NT
- Sarı ME
- Celik H
- Dede M
- Akbayır O
- Güngördük K
- Åžahin H
- Haberal A
- Güngör T
- Arvas M
- Meydanlı
- Affiliations
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- 1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey.
- 2Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey. drerkansari@gmail.com
- 3Department of Obstetrics and Gynecology, Gulhane Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
- 4Department of Gynecologic Oncology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul, Turkey.
- 5Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey.
- 6Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
- KMID: 2395239
- DOI: http://doi.org/10.3802/jgo.2018.29.e12
Abstract
OBJECTIVE
The purpose of this study was to investigate the prognostic value of lymph node ratio (LNR) in patients with stage III ovarian high-grade serous carcinoma (HGSC).
METHODS
A multicenter, retrospective department database review was performed to identify patients with ovarian HGSC at 6 gynecologic oncology centers in Turkey. A total of 229 node-positive women with stage III ovarian HGSC who had undergone maximal or optimal cytoreductive surgery plus systematic lymphadenectomy followed by paclitaxel plus carboplatin combination chemotherapy were included. LNR, defined as the percentage of positive lymph nodes (LNs) to total nodes recovered, was stratified into 3 groups: LNR1 (<10%), LNR2 (10%≤LNR<50%), and LNR3 (≥50%). Kaplan-Meier method was used to generate survival data. Factors predictive of outcome were analyzed using Cox proportional hazards models.
RESULTS
Thirty-one women (13.6%) were classified as stage IIIA1, 15 (6.6%) as stage IIIB, and 183 (79.9%) as stage IIIC. The median age at diagnosis was 56 (range, 18-87), and the median duration of follow-up was 36 months (range, 1-120 months). For the entire cohort, the 5-year overall survival (OS) was 52.8%. An increased LNR was associated with a decrease in 5-year OS from 65.1% for LNR1, 42.5% for LNR2, and 25.6% for LNR3, respectively (p<0.001). In multivariate analysis, women with LNR≥0.50 were 2.7 times more likely to die of their tumors (hazard ratio [HR]=2.7; 95% confidence interval [CI]=1.42-5.18; p<0.001).
CONCLUSION
LNR seems to be an independent prognostic factor for decreased OS in stage III ovarian HGSC patients.
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