INTRODUCTION: It has been hypothesized that the supradiaphragmatic lymph nodes serve as the principal nodes for lymphatic drainage of the entire peritoneal cavity. The purpose of this study was to determine the prognostic significance of enlarged supradiaphragmatic nodes noted on preoperative computed tomographic (CT) scan in patients undergoing primary cytoreduction for advanced epithelial ovarian cancer (EOC). METHODS: We performed a retrospective chart review of all patients with stage III and IV EOC according to the International Federation of Gynecology and Obstetrics who had preoperative CT scans, including the supradiaphragmatic region, and had undergone primary cytoreductive surgery at our institution between January 1997 and June 2004. Scans were retrospectively reviewed by a radiologist. We defined supradiaphragmatic adenopathy as nodes measuring greater than 5 mm on the largest of 2 perpendicular measurements on the CT scan. The Fisher exact test was used to compare proportions. Kaplan-Meier curves and log-rank tests were used for the survival analyses. RESULTS: A total of 212 evaluable patients were identified. All underwent attempted primary cytoreduction followed by systemic chemotherapy. None had any supradiaphragmatic nodes removed at primary cytoreduction. With a median follow-up time of 52 months, median overall survival for the entire cohort was 48 months. Of 212 patients, 92 (43%) had supradiaphragmatic adenopathy. Median survival was 50 months for patients without adenopathy and 45 months for patients with adenopathy (P = 0.09). Of the 212 patients, 155 (73%) underwent optimal cytoreduction. In these patients, median survival was 55 months for the 91 without adenopathy and 50 months for the 64 patients with supradiaphragmatic adenopathy (P = 0.09). CONCLUSIONS: We observed a trend toward worse survival in patients with enlarged supradiaphragmatic nodes. The prognostic impact of supradiaphragmatic adenopathy remains uncertain and deserves further study.
INTRODUCTION: It has been hypothesized that the supradiaphragmatic lymph nodes serve as the principal nodes for lymphatic drainage of the entire peritoneal cavity. The purpose of this study was to determine the prognostic significance of enlarged supradiaphragmatic nodes noted on preoperative computed tomographic (CT) scan in patients undergoing primary cytoreduction for advanced epithelial ovarian cancer (EOC). METHODS: We performed a retrospective chart review of all patients with stage III and IV EOC according to the International Federation of Gynecology and Obstetrics who had preoperative CT scans, including the supradiaphragmatic region, and had undergone primary cytoreductive surgery at our institution between January 1997 and June 2004. Scans were retrospectively reviewed by a radiologist. We defined supradiaphragmatic adenopathy as nodes measuring greater than 5 mm on the largest of 2 perpendicular measurements on the CT scan. The Fisher exact test was used to compare proportions. Kaplan-Meier curves and log-rank tests were used for the survival analyses. RESULTS: A total of 212 evaluable patients were identified. All underwent attempted primary cytoreduction followed by systemic chemotherapy. None had any supradiaphragmatic nodes removed at primary cytoreduction. With a median follow-up time of 52 months, median overall survival for the entire cohort was 48 months. Of 212 patients, 92 (43%) had supradiaphragmatic adenopathy. Median survival was 50 months for patients without adenopathy and 45 months for patients with adenopathy (P = 0.09). Of the 212 patients, 155 (73%) underwent optimal cytoreduction. In these patients, median survival was 55 months for the 91 without adenopathy and 50 months for the 64 patients with supradiaphragmatic adenopathy (P = 0.09). CONCLUSIONS: We observed a trend toward worse survival in patients with enlarged supradiaphragmatic nodes. The prognostic impact of supradiaphragmatic adenopathy remains uncertain and deserves further study.
Authors: Katrijn L M Michielsen; Ignace Vergote; Raphaëla Dresen; Katya Op de Beeck; Ragna Vanslembrouck; Frédéric Amant; Karin Leunen; Philippe Moerman; Steffen Fieuws; Frederik De Keyzer; Vincent Vandecaveye Journal: Br J Radiol Date: 2016-09-21 Impact factor: 3.039
Authors: Marcelo A Queiroz; Rahel A Kubik-Huch; Nik Hauser; Bianka Freiwald-Chilla; Gustav von Schulthess; Johannes M Froehlich; Patrick Veit-Haibach Journal: Eur Radiol Date: 2015-05-29 Impact factor: 5.315
Authors: Katrijn Michielsen; Ignace Vergote; Katya Op de Beeck; Frederic Amant; Karin Leunen; Philippe Moerman; Christophe Deroose; Geert Souverijns; Steven Dymarkowski; Frederik De Keyzer; Vincent Vandecaveye Journal: Eur Radiol Date: 2013-12-11 Impact factor: 5.315
Authors: Renee A Cowan; Jill Tseng; Vijayashree Murthy; Radhika Srivastava; Kara C Long Roche; Oliver Zivanovic; Ginger J Gardner; Dennis S Chi; Bernard J Park; Yukio Sonoda Journal: Gynecol Oncol Date: 2017-09-06 Impact factor: 5.482
Authors: 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 Journal: BMC Cancer Date: 2018-11-26 Impact factor: 4.430