Elisabet Hjerpe1,2, Christian Staf3, Pernilla Dahm-Kähler4, Karin Stålberg5, Maria Bjurberg6, Erik Holmberg3,7, Christer Borgfeldt8, Bengt Tholander9, Kristina Hellman1,2, Preben Kjølhede10,11, Thomas Högberg12, Per Rosenberg13, Elisabeth Åvall-Lundqvist2,13. 1. a Department of Oncology and Pathology , Karolinska University Hospital , Stockholm , Sweden. 2. b Department of Oncology and Pathology , Karolinska Institute , Stockholm , Sweden. 3. c Regional Cancer Center Western Sweden , Sahlgrenska University Hospital , Gothenburg , Sweden. 4. d Department of Obstetrics and Gynecology , Sahlgrenska University Hospital , Gothenburg , Sweden. 5. e Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden. 6. f Department of Hematology, Oncology and Radiation Physics , Skåne University Hospital, and Department of Clinical Sciences, Lund University , Lund , Sweden. 7. g Institute of Clinical Sciences , Sahlgrenska Academy , Gothenburg , Sweden. 8. h Department of Obstetrics and Gynecology , Skåne University Hospital and Lund University , Lund , Sweden. 9. i Department of Oncology , Uppsala University Hospital , Uppsala , Sweden. 10. j Department of Obstetrics and Gynecology , Linköping University Hospital , Linköping , Sweden. 11. k Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden. 12. l Department of Cancer Epidemiology , Lund University , Lund , Sweden. 13. m Department of Clinical Oncology and Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden.
Abstract
BACKGROUND: The International Federation of Gynecology and Obstetrics (FIGO) ovarian cancer staging system includes no sub-stage for lymph nodes (LN) as only distant disease manifestation. We explore the prognostic implication of LN as only stage IV classifier in serous ovarian cancer. METHOD: This is a nation-wide, population-based study on 551 women with serous stage IV cancers diagnosed between 2009-2014. We compare overall survival (OS) in women with LN as only distant metastatic site to those with pleural metastases only and to patients with other/multiple stage IV manifestations. Cox regression models were used for uni- and multivariable estimations. RESULTS: Of 551stage IV cases, distant metastatic site was registered in 433. Median OS for women with LN (n = 51) was 41.4 months, compared to 25.2 and 26.8 months for patients with pleural (n = 195) or other/multiple (n = 187) distant metastases (p = .0007). The corresponding five-year survival rates were 32, 11 and 22%, respectively. Multivariable analyzes confirmed shorter survival for women with pleural (HR 2.99, p = .001) or other/multiple distant sites (HR 2.67, p = .007), as compared to LN cases. LN only patients lived 9.1 months longer after primary than after interval surgery, but this difference was not significant (p = .245). CONCLUSION: Women with stage IV serous ovarian cancer having lymph nodes as only distant metastatic site live longer than other stage IV patients.
BACKGROUND: The International Federation of Gynecology and Obstetrics (FIGO) ovarian cancer staging system includes no sub-stage for lymph nodes (LN) as only distant disease manifestation. We explore the prognostic implication of LN as only stage IV classifier in serous ovarian cancer. METHOD: This is a nation-wide, population-based study on 551 women with serous stage IV cancers diagnosed between 2009-2014. We compare overall survival (OS) in women with LN as only distant metastatic site to those with pleural metastases only and to patients with other/multiple stage IV manifestations. Cox regression models were used for uni- and multivariable estimations. RESULTS: Of 551stage IV cases, distant metastatic site was registered in 433. Median OS for women with LN (n = 51) was 41.4 months, compared to 25.2 and 26.8 months for patients with pleural (n = 195) or other/multiple (n = 187) distant metastases (p = .0007). The corresponding five-year survival rates were 32, 11 and 22%, respectively. Multivariable analyzes confirmed shorter survival for women with pleural (HR 2.99, p = .001) or other/multiple distant sites (HR 2.67, p = .007), as compared to LN cases. LN only patients lived 9.1 months longer after primary than after interval surgery, but this difference was not significant (p = .245). CONCLUSION:Women with stage IV serous ovarian cancer having lymph nodes as only distant metastatic site live longer than other stage IV patients.
Authors: Dimitrios Nasioudis; Emily M Ko; Ashley F Haggerty; Robert L Giuntoli; Robert A Burger; Mark A Morgan; Nawar A Latif Journal: Gynecol Oncol Rep Date: 2019-03-13
Authors: Elina A Pietilä; S Pauliina Turunen; Lidia Moyano-Galceran; Sara Corvigno; Elisabet Hjerpe; Daria Bulanova; Ulrika Joneborg; Twana Alkasalias; Yuichiro Miki; Masakazu Yashiro; Anastasiya Chernenko; Joonas Jukonen; Madhurendra Singh; Hanna Dahlstrand; Joseph W Carlson; Kaisa Lehti Journal: EMBO Mol Med Date: 2020-03-02 Impact factor: 12.137