Staging lymphadenectomy in patients with clear cell carcinoma of the ovary Journal Article


Authors: Mueller, J. J.; Holzapfel, M.; Han, C. H.; Santos, K.; Gunderson, C.; Moore, K.; Erickson, B.; Leath, C. A.; Diaz, E.; Walsh, C.; Wethington, S. L.; Dejbakhsh, S. Z.; Barakat, R. R.; Gardner, G. J.; Hyman, D. M.; Soslow, R. A.; Leitao, M. M.
Article Title: Staging lymphadenectomy in patients with clear cell carcinoma of the ovary
Abstract: Objective The purpose of this study was to assess the rate of lymph node (LN) metastasis in comprehensively staged ovarian clear cell carcinoma (OCCC) clinically confined to the ovary and determine factors associated with LN metastasis. Methods We identified all cases of OCCC treated at 4 institutions from January 1994 through December 2011. We included cases with disease grossly confined to the ovary that had surgical staging performed, including at least 10 LNs sampled. Clinical and pathologic data were abstracted from electronic medical records, and a deidentified data set was compiled and processed at a single institution. Factors potentially associated with LN metastasis were tested. Appropriate statistical tests were performed. Results We identified 145 eligible cases that met the criteria for this analysis. Median age was 52.9 years (range, 30-81 years), and median total LN count was 19 (range, 10-74). Seven (4.8%) of 145 comprehensively staged cases had LN metastasis; 6 of these cases (4.1%) were isolated metastasis. Cytologic washings, peritoneal, omental, and fallopian tube involvement were not associated with nodal metastasis. Cases with ovarian surface involvement and positive cytology had a 37.5% incidence of LN positivity, which was statistically meaningful when compared with all other cases (P = 0.003). Conclusions Women who underwent comprehensive staging for clinical stage I OCCC had an LN metastasis rate of 4.8%. The subgroup of cases with both ovarian surface involvement and positive cytology had the highest incidence of LN metastasis. This may influence clinical decision making on whether to perform lymphadenectomy in patients with incidental OCCC found after salpingo-oophorectomy. © 2015 by IGCS AND ESGO.
Keywords: staging; ovarian cancer; metastasis; lymph node
Journal Title: International Journal of Gynecological Cancer
Volume: 26
Issue: 1
ISSN: 1048-891X
Publisher: Lippincott Williams & Wilkins  
Date Published: 2016-01-01
Start Page: 120
End Page: 124
Language: English
DOI: 10.1097/igc.0000000000000559
PROVIDER: scopus
PUBMED: 26509849
PMCID: PMC4891809
DOI/URL:
Notes: Conference Paper -- Export Date: 3 February 2016 -- Source: Scopus
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  1. Ginger J Gardner
    270 Gardner
  2. Richard R Barakat
    629 Barakat
  3. Mario Leitao
    575 Leitao
  4. Robert Soslow
    793 Soslow
  5. David Hyman
    354 Hyman
  6. Kevin Santos
    8 Santos
  7. Jennifer Jean Mueller
    186 Mueller
  8. Chan Hee Han
    1 Han