Relationship between Paraaortic Lymph Node Involvement and Intraperitoneal Spread in Patients with Ovarian Cancer—A Multivariate Analysis

Introduction:Uterine papillary serous and clear cell carcinomas (UPSCs/CCs) show a different spreading from that of poorly differentiated endometrioid carcinomas (PDECs) and are usually thought to be prognostically more aggressive than PDECs. On the contrary, it has been recently claimed that UPSC/CC and PDEC have a similar prognosis. In this retrospective study on 2 institutional databases, the surgical-pathological data and survival have been compared in patients with UPSC/CC and PDEC.Methods:A total of 139 surgically staged consecutive patients, 63 with UPSC/CC (37 UPSC; 26 CC) and 76 with PDEC clinically limited to the uterine corpus, have been compared for nuclear ploidy, myometrial invasion, (occult) cervical extension, peritoneal, and lymph node metastasis. Prognostic factors have been correlated through multivariate analysis with survival (disease-specific [DSS] and disease-free [DFS]).Results:Peritoneal metastases and aneuploidy were found to be the only parameters significantly different in the 2 groups: peritoneal metastases 28.6% in UPSC/CC (extrapelvic 19%) and 7.9% in PDEC (extrapelvic 2.6%) (P= 0.001), aneuploidy 48.6% in UPSC/CC and 30.6% in PDEC (P= 0.05). Five-year DSS was 57.9% versus 75.2% (P= 0.02), and DFS was 52.3% versus 71.4% (P= 0.04) for UPSC/CC and PDEC, respectively. All but cervical and lymph node involvement were significant predictors of survival. After multivariate analysis, histotype (DSS: hazard ratio [HR], 1.98; 95% confidence interval [CI], 1.02-3.86;P= 0.04; DFS: HR, 1.94; 95% CI, 1.04-3.63;P= 0.04), stage (DSS: HR, 2.26; 95% CI, 1.10-4.65;P= 0.03; DFS: HR, 2.21; 95% CI, 1.12-4.38;P= 0.02), and myometrial invasion (DSS: HR, 2.86; 95% CI, 1.22-6.69;P= 0.01; DFS: HR, 3.96; 95% CI, 1.63-9.62;P= 0.002) were independent risk factors for survival.Conclusions:Uterine papillary serous and clear cell carcinomas spread to abdominal peritoneum more frequently than PDEC; multivariate analysis confirms UPSC/CC as an independent, unfavorable predictor of outcome.

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Relationship between Pelvic Lymph Node Involvement and Other Disease Sites in Patients with Ovarian Cancer

Gynecologic Oncology ◽

10.1006/gyno.1997.4624 ◽

1997 ◽

Vol 65 (1) ◽

pp. 164-168 ◽

Cited By ~ 26

Author(s):

Kunihiro Sakai ◽

Toshiharu Kamura ◽

Toshio Hirakawa ◽

Toshiaki Saito ◽

Tsunehisa Kaku ◽

...

Keyword(s):

Ovarian Cancer ◽

Lymph Node ◽

Lymph Node Involvement ◽

Pelvic Lymph Node ◽

Node Involvement ◽

Pelvic Lymph Node Involvement

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Impact of surgery and chemotherapy on survival in patients with advanced cholangiocarcinoma: A multivariate analysis in a cohort of 242 consecutive patients

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.4133 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 4133-4133

Author(s):

C. Dreyer ◽

C. Le Tourneau ◽

S. Faivre ◽

V. Paradis ◽

Q. Zhan ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Lymph Node ◽

Median Survival ◽

Tumor Size ◽

Positive Impact ◽

Univariate Analysis ◽

Lymph Node Involvement ◽

Node Involvement ◽

The Impact

4133 Background: Cholangiocarcinoma remains an orphan disease for which prospective studies are missing to evaluate the impact of systemic chemotherapy on survival. Methods: Univariate and multivariate analysis of parameters that might impact survival were analyzed in a cohort of 242 consecutive patients with cholangiocarcinoma treated in a single institution between 2000 and 2004. Variables were WHO performance status (PS), age, symptoms, tumor size, extent of the disease, lymph node involvement, site of metastasis, tumor markers, pathology, and type of treatment including surgery, chemotherapy and radiotherapy. Results: Statistically significant prognostic factors of survival in univariate analysis are displayed in the table : In multivariate analysis, PS, tumor size and surgery were independent prognostic factors. Subgroup analysis demonstrated that in patients with advanced diseases (lymph node involvement, peritoneal carcinomatosis and/or distant metastasis), patients who had no surgery benefited of chemotherapy (median survival 13.1 versus 7.4 months in patients with/without chemotherapy, p = 0.006). Moreover, survival was further improved when patients could benefit of chemotherapy following total and/or partial resection (median survival 22.9 versus 13.0 months in patients with/without chemotherapy, p = 0.03). Conclusions: This study strongly suggests the positive impact on survival of multimodality approaches including surgery and chemotherapy in patients with advanced cholangiocarcinoma. [Table: see text] No significant financial relationships to disclose.

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