Abstract
BackgroundSupradiaphragmatic lymph node metastases (SdLNM) are frequently identified using 18F-FDG positron emission tomography/computed tomography (PET/CT) in advanced epithelial ovarian cancers (AEOC). This study aimed to determine the prognostic significance of SdLNM detected by PET/CT in patients with AEOC.MethodsMedical records of patients diagnosed with AEOC were retrospectively registered from January 2009 to July 2015. Patients were categorized according to PET/CT stage: PET/CT stage III, PET/CT stage IV with SdLNM, and PET/CT stage IV with other metastases. Clinicopathologic characteristics, recurrence patterns, survival outcomes were compared according to PET/CT stage. Anatomical distribution of SdLNM and effect of thoracic debulking surgery were estimated.ResultsA total of 295 patients were identified, including 176 patients who underwent primary debulking surgeries (PDS). Progression-free (P = 0.671) and overall (P = 0.525) survival did not differ significantly between patients with PET/CT IV with SdLNM and PET/CT IV with other metastases; however, patients with PET/CT IV with SdLNM had significantly poorer progression-free (P < 0.001) and overall (P = 0.016) survival than those with PET/CT stage III. Recurrence patterns were similar in all groups; intraperitoneal metastasis was the most common (78.8%) and thoracic recurrence alone accounted for less than 10%. Debulking of SdLNM lesions did not improve progression-free survival (P = 0.425) or overall survival (P = 0.465) of patients with AEOC.ConclusionsSdLNM detected using preoperative PET/CT are a negative prognostic factor in AEOC. Resection of suspicious SdLNM may not have effect to survival of patients with AEOC.
Highlights
Supradiaphragmatic lymph node metastases (SdLNM) are frequently identified using 18F-FDG positron emission tomography/computed tomography (PET/CT) in advanced epithelial ovarian cancers (AEOC)
Fruscio et al found that PET/CT led to an upstaging of about one fourth of ovarian cancer patients from stage III to IV after SdLNM detection [8]; they concluded that the prognosis of patients with stage IV metastases detected by PET/CT was similar to that of those at stage IIIC
The PET/CT stage IV group was divided into two sub-groups: one group included patients who had 18F-FDG uptake only in supradiaphragmatic lymph nodes (SdLN), without evidence of lesions outside the abdomen or of other organ involvement (PET/CT IV SdLNM), and the other group included patients with distant organ involvement, such as the liver, spleen, and lung parenchyma, regardless of SdLN involvement (PET/CT IV other)
Summary
Supradiaphragmatic lymph node metastases (SdLNM) are frequently identified using 18F-FDG positron emission tomography/computed tomography (PET/CT) in advanced epithelial ovarian cancers (AEOC). Complete tumor resection is important in patients with advanced epithelial ovarian cancer (AEOC). After introducing of 18F-FDG positron emission tomography/computed tomography (PET/CT) scanning for preoperative evaluation, extraperitoneal disease has raised further questions about management of AEOC. Recurrence pattern of stage IV ovarian cancer patients was evaluated to determine the benefit of thoracic cytoreduction [9]; since thorax-only recurrence was very rare, the authors assumed that thoracic debulking would not change the course of stage IV ovarian cancer. This study aimed to determine the prognostic significance of SdLNM detected using PET/CT in patients with AEOC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
