Effect of the N Factor on the Prognosis of pT3C Ovarian Cancer With Optimal Debulking Surgery

Abstract

IntroductionThe primary debulking surgery that is performed to achieve complete debulking is one of the most important prognostic factors in patients with advanced ovarian cancer. However, the relationship between lymph node metastases and the surgical outcome is still unclear. This study analyzed the effect of the N factor on the prognosis of patients with pT3C ovarian cancer who underwent optimal surgery (OpS). Patients and MethodsThe participants were 68 patients with pT3C serous adenocarcinoma. The overall survival (OS) and the median survival time (MST) were analyzed by the diameter of the residual tumor and by lymph node metastasis using the Kaplan-Meier method and the log-rank test. The patients received retroperitoneal lymph node dissection in the pelvic cavity up to the para-aortic lymph nodes. The patients in the OpS group were further divided into a complete-surgery group with no residual tumor and a group with residual tumor of less than 1 cm, and differences were analyzed. ResultsThe OS rates in the OpS group and Sub-OpS group were 77.5% and 11.1%, respectively. According to the analyses made by different levels of lymph node metastasis in all patients, the OS rates in patients with N0 and N1 disease were 77.1% and 47.5%, respectively; the prognosis was significantly poorer in the N1 group. According to the analyses of the N factor in the OpS group, the prognosis was significantly poorer in the N1 group even with OpS compared with that in the N0 group (53.7% and 86.6%, respectively). Furthermore, in the N1 group with OpS, the prognosis was significantly better in the complete-surgery group than in the other group with residual tumor of less than 1 cm (77.8% and 16.7%, respectively). ConclusionThe prognosis of pT3CpN1 ovarian cancer with OpS was as poor as with Sub-OpS. However, the results suggested that the prognosis could be improved if the tumor was completely resected in OpS.