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Open Access Research

Clinical features and outcomes of neck lymphatic metastasis in ovarian epithelial carcinoma

Chien-Wen Chen12, Pao-Ling Torng1*, Chi-Ling Chen3 and Chi-An Chen1

Author Affiliations

1 Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung Shan South Road, Taipei 10002, Taiwan

2 Department of Health, Penghu Hospital, 10 Chung-Cheng Road, Makung, Penghu 880-41, Taiwan

3 Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, No. 7, Chung Shan South Road, Taipei 10002, Taiwan

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World Journal of Surgical Oncology 2013, 11:255  doi:10.1186/1477-7819-11-255

Published: 3 October 2013

Abstract

Background

Neck lymph node metastasis (NLNM) in epithelial ovarian cancer (EOC) is rare and treated as advanced stage cancer. However, ovarian cancer with lymphatic metastasis may manifest a different clinical course from peritoneal carcinomatosis.

Methods

The authors retrospectively assessed 20 patients with EOC and pathologically diagnosed as NLNM between January 2001 and December 2010. The patients were divided into two groups according to the time of NLNM identification. Statistical methods included Kaplan-Meier, log-rank, and Cox regression analysis.

Results

Eleven patients were diagnosed with NLNM at the same time of surgical exploration of EOC (Group A) and nine patients at cancer recurrence 43.3 months after initial surgery (Group B). In Group A, patients with tumors confined to the pelvic cavity had no recurrence or had isolated lymph node recurrence (ILNR), and survived longer than patients with abdominal tumor spreading (P = 0.0007). In Group B, 2 patients showed ILNR. The median survival time after NLNM was 42 months in Group A and 6 months in Group B (P = 0.01). Cox model demonstrated that non-serous histology, brain metastasis, and NLNM identified at cancer recurrence were major predictors for poor overall survival (Hazard ratio [HR] = 18.67, 6.93, and 4.52; P = 0.01, 0.02, and 0.04, respectively).

Conclusions

A subgroup of EOC patients with NLNM who presented limited pelvic cancer had much better overall survival than patients who had cancer spreading beyond the pelvic cavity or were diagnosed with NLNM at cancer recurrence.

Keywords:
Epithelial ovarian cancer; Neck lymph node metastasis; Survival