Pelvic and paraortic lymph nodal status in advanced ovarian cancer and survival

Background. In order to analyze the prognostic role of node involvement in advanced ovarian cancer, we have analyzed data from a randomized clinical t rial on advanced ovarian cancer. Methods. Cases were 456 women who entered a randomized multicentric clinica l trial comparing two cisplatin-based schemes of treatment after cytoreduct ive surgery for advanced stage III-IV ovarian cancer. They underwent select ive pelvic and/or paraortic lymphadenectomy. Results. A total of 161 (35.3%) cases had positive nodes. The frequency of positive nodes was statistically significantly higher in FIGO stage IV than in stage III. Also grade 3 tumors were more likely to have positive nodes than grade 1-2 tumors. No association was observed between nodal status and response to chemotherapy. The 3-year survival was 46.2 (standard error (SE ) = 3.4 based on 147 deaths) and 44.6 (SE = 4.4, based on 84 deaths), respe ctively, in negative and positive node groups, The corresponding values, wh en the analysis was performed considering only subjects with residual tumor <1 cm or absent, after first-line cytoreductive surgery were 66.2 (SE = 5. 7) and 62.4 (SE = 9.6). Conclusions. We did not find any association between nodal status and survi val. Particularly, nodal status was not a prognostic factor for survival in the subgroup of women with residual tumor <1 cm or absent after cytoreduct ive surgery. (C) 1999 academic Press.