Prognostic significance of supraclavicular lymphadenopathy in patients with high-grade serous ovarian cancer Journal Article

Authors: Cybulska, P.; Hayes, S. A.; Spirtos, A.; Rafizadeh, M. J.; Filippova, O. T.; Leitao, M.; Zivanovic, O.; Sonoda, Y.; Mueller, J.; Lakhman, Y.; Long, K.; Chi, D. S.
Article Title: Prognostic significance of supraclavicular lymphadenopathy in patients with high-grade serous ovarian cancer
Abstract: Objectives To assess outcomes and patterns of recurrence in patients with high-grade serous ovarian/tubal/primary peritoneal cancers with radiographic supraclavicular lymphadenopathy at diagnosis. Methods We evaluated all patients with newly diagnosed high-grade serous ovarian cancers treated at our center between January 1, 2008 and May 1, 2013 who had supraclavicular lymphadenopathy (defined as ≥1 cm in short axis) on radiographic imaging (either computed tomography or positron emission tomography) at the time of diagnosis. Results Of 586 patients with high-grade serous ovarian cancer receiving primary treatment during the study period, we identified 13 (2.2%) with supraclavicular lymphadenopathy diagnosed on pre-treatment imaging. The median age at diagnosis was 52.0 years (range 38.2-72.3). Five (31%) had clinically palpable nodes on physical examination. Four (31%) had a known BRCA mutation. All 13 patients underwent neoadjuvant chemotherapy, followed by interval debulking surgery. Each patient received a median of four cycles of neoadjuvant intravenous chemotherapy (range 3-7). At interval debulking surgery, complete gross resection was achieved in nine (70%) patients, and optimal resection (0.1-1 cm residual disease) in four (30%). Eleven patients (85%) recurred; however, only one (8%) recurred in the supraclavicular lymph nodes. Median follow-up time was 44.3 months (range 22.4-95.0). Median progression-free survival for the cohort was 11.7 months (95% CI 9.2 to 14.1). Median overall survival was 44.3 months (95% CI 41.5 to 47.1). In patients obtaining complete gross resection at interval debulking surgery, median progression-free survival and overall survival were 13.9 months (95% CI 8.9 to 18.9) and 78.1 months (95% CI 11.1 to 145.1), respectively. Conclusions In our study, approximately 2% of patients with high-grade serous ovarian cancer presented with radiographic evidence of supraclavicular lymphadenopathy. Supraclavicular lymphadenopathy at diagnosis did not portend an unfavorable outcome when complete gross resection was achieved at interval debulking surgery. © IGCS and ESGO 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords: adult; aged; survival rate; major clinical study; overall survival; cancer recurrence; follow up; ovarian cancer; cytoreductive surgery; progression free survival; ovary cancer; cohort analysis; physical examination; neoadjuvant chemotherapy; lymphadenopathy; clinical outcome; surgical oncology; cancer prognosis; human; female; priority journal; article; median survival time; high grade serous ovarian cancer; supraclavicular lymph node
Journal Title: International Journal of Gynecological Cancer
Volume: 29
Issue: 9
ISSN: 1048-891X
Publisher: Lippincott Williams & Wilkins  
Date Published: 2019-11-01
Start Page: 1377
End Page: 1380
Language: English
DOI: 10.1136/ijgc-2019-000829
PUBMED: 31575614
PROVIDER: scopus
Notes: Article -- Export Date: 2 December 2019 -- Source: Scopus
Citation Impact
MSK Authors
  1. Yuliya Lakhman
    40 Lakhman
  2. Dennis S Chi
    525 Chi
  3. Yukio Sonoda
    308 Sonoda
  4. Mario Leitao
    346 Leitao
  5. Oliver Zivanovic
    147 Zivanovic
  6. Kara Christine Long
    79 Long
  7. Sara Anne Hayes
    24 Hayes
  8. Jennifer Jean Mueller
    44 Mueller