Role of Lymphadenectomy in Treating Ovarian Cancer
Posted: Wednesday, March 13, 2019
Although systematic pelvic and para-aortic lymphadenectomy is widely used in the surgical treatment of women with advanced ovarian cancer, a new study found that lymphadenectomy did not improve survival in patients with advanced ovarian cancer and clinically negative lymph nodes. In fact, Philipp Harter, MD, PhD, of Stanford University School of Medicine and colleagues, found that patients who underwent surgery were more likely to experience postoperative complications than those who did undergo lymphadenectomy. The study was published in The New England Journal of Medicine.
The authors randomly assigned 647 women with normal lymph nodes before and during macroscopically complete resection to undergo (n = 323) or not undergo lymphadenectomy (n = 324). Eligible patients had stage IIB through IV ovarian cancer and a good performance status. The participating surgical centers had to meet a set of qualifying criteria before participating in the trial.
Patients who underwent lymphadenectomy had a median overall survival of 65.5 months versus 69.2 months among those who did not have the procedure (P = .65). The median progression-free survival was 25.5 months in both groups (P = .29). Postoperative complications were more frequent among the women who underwent lymphadenectomy. Serious postoperative complications occurred in 12.4% of the lymphadenectomy group and 6.5% of those in the no-lymphadenectomy group (P = .01). Lymphadenectomy also was associated with a higher mortality rates within 60 days after surgery (3.1% vs. 0.9%; P = .049).
Disclosure: The study authors’ disclosure information may be found at nejm.org.