Systematic Lymph Node Dissection During Interval Debulking Surgery for Advanced Epithelial Ovarian Cancer: a Systematic Review and Meta-analysis

Overview

Journal J Gynecol Oncol

Specialties Gynecology & Obstetrics
Oncology

Date 2022 Jul 26

PMID 35882606

Authors

Giuseppe Caruso

Innocenza Palaia

Giorgio Bogani

Federica Tomao

Giorgia Perniola

Pierluigi Benedetti Panici

Ludovico Muzii

Violante Di Donato

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the efficacy and safety of systematic lymph node dissection (SyLND) at the time of interval debulking surgery (IDS) for advanced epithelial ovarian cancer (AEOC).

Methods: Systematic literature review of studies including AEOC patients undergoing SyLND versus selective lymph node dissection (SeLND) or no lymph node dissection (NoLND) after neoadjuvant chemotherapy (NACT). Primary endpoints included progression-free survival (PFS) and overall survival (OS). Secondary endpoints included severe postoperative complications, lymphocele, lymphedema, blood loss, blood transfusions, operative time, and hospital stay.

Results: Nine retrospective studies met the eligibility criteria, involving a total of 1,660 patients: 827 (49.8%) SyLND, 490 (29.5%) SeLND, and 343 (20.7%) NoLND. The pooled estimated hazard ratios (HR) for PFS and OS were, respectively, 0.88 (95% confidence interval [CI]=0.65-1.20; p=0.43) and 0.80 (95% CI=0.50-1.30; p=0.37). The pooled estimated odds ratios (ORs) for severe postoperative complications, lymphocele, lymphedema, and blood transfusions were, respectively, 1.83 (95% CI=1.19-2.82; p=0.006), 3.38 (95% CI=1.71-6.70; p<0.001), 7.23 (95% CI=3.40-15.36; p<0.0001), and 1.22 (95% CI=0.50-2.96; p=0.67).

Conclusion: Despite the heterogeneity in the study designs, SyLND after NACT failed to demonstrate a significant improvement in PFS and OS and resulted in a higher risk of severe postoperative complications.

Trial Registration: PROSPERO Identifier: CRD42022303577.

Citing Articles

Questionnaire-based survey on the extent of lymph node dissection during interval debulking surgery after neoadjuvant chemotherapy for patients with advanced ovarian cancer in the Gynecologic Cancer Study Group of JCOG.

Iida Y, Kobayashi-Kato M, Komatsu H, Ishikawa M, Satoh T Int J Clin Oncol. 2025; .

PMID: 40053172 DOI: 10.1007/s10147-025-02734-0.

Prognostic impact of microscopic residual disease after neoadjuvant chemotherapy in patients undergoing interval debulking surgery for advanced ovarian cancer.

Di Donato V, Caruso G, Golia DAuge T, Perniola G, Palaia I, Tomao F Arch Gynecol Obstet. 2024; 311(2):429-436.

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Nomogram for predicting lymph node metastasis in patients with ovarian cancer using ultrasonography: a multicenter retrospective study.

Yang Y, Ye X, Zhou B, Liu Y, Feng M, Lv W BMC Cancer. 2023; 23(1):1121.

PMID: 37978453 PMC: 10655276. DOI: 10.1186/s12885-023-11624-5.

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