Patients with ovarian carcinoma upstaged to Stage III after systematic lymphadenctomy have similar survival to Stage I/II patients and superior survival to other Stage III patients

BACKGROUND Patients with epithelial ovarian carcinoma upstaged from Stage I/II to Stage IIIC based on lymph node involvement are known to have poor prognoses. The authors investigated whether systematic aortic and pelvic lymphadenectomy would affect the prognoses of these patients. METHODS During the period 1987-1996, 103 patients in Stage I-III underwent optimal cytoreductive surgery with systematic aortic and pelvic lymphadenectomy at initial surgery. All patients except for those in Stage IA received adjuvant cisplatin-based chemotherapy after surgery. Of 67 patients with intraperitoneal tumors limited to the pelvis, 14 were upstaged to Stage III based on lymph node positivity (Group A). The authors compared the survival of Group A patients with that of 53 patients who had intraperitoneal tumors limited to the pelvis and negative lymph nodes (Group B), and also with that of 36 patients who had intraperitoneal tumors beyond the pelvis irrespective of lymph node status (Group C). RESULTS The 5-year survival of Group A patients in Stage III based only on lymph node positivity had fairly good survival, although it was not significantly different from that of Group B patients in Stage I/II (84% vs. 96%, P = 0.107). Group A had much better 5-year survival than Group C patients who were considered to be Stage III because they had intraperitoneal tumors beyond the pelvis (84% vs. 26%, P = 0.042). CONCLUSIONS Relatively good survival was observed for patients with intraperitoneal tumors limited to the pelvis and lymph node involvement who underwent systematic aortic and pelvic lymphadenectomy. Cancer 1998;83:1555-1560. © 1998 American Cancer Society.