Patients with macroscopic lymph node metastasis expect poor prognosis after neoadjuvant chemotherapy in advanced ovarian cancer: a retrospective cohort study based on a single gynecological team
Abstract Objective To investigate the prognostic impact of metastatic lymph nodes (MLNs) on advanced epithelial ovarian cancer (EOC) patients receiving neoadjuvant chemotherapy (NACT). Methods This was a retrospective cohort study using data from patients managed by a single gynecological team betwe...
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2025-05-01
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| Online Access: | https://doi.org/10.1186/s12885-025-14237-2 |
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| author | Wen Guo Jie Yin Yu Gu Yin Shan Wei Wang Yan Li Meng Qin Jiayu Chen Ying Jin Lingya Pan |
| author_facet | Wen Guo Jie Yin Yu Gu Yin Shan Wei Wang Yan Li Meng Qin Jiayu Chen Ying Jin Lingya Pan |
| author_sort | Wen Guo |
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| description | Abstract Objective To investigate the prognostic impact of metastatic lymph nodes (MLNs) on advanced epithelial ovarian cancer (EOC) patients receiving neoadjuvant chemotherapy (NACT). Methods This was a retrospective cohort study using data from patients managed by a single gynecological team between June 2012 and June 2023. Among EOC patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC or IV disease, patients who received NACT and who underwent complete cytoreduction during interval debulking surgery were included (the NACT cohort), together with patients who received primary debulking surgery (PDS, including those with both complete and incomplete cytoreduction). Clinically suspicious lymph nodes at diagnosis and/or debulking surgeries were resected. Differences in terms of clinicopathological features, survival profiles, and recurrence patterns were analyzed between groups with different lymph node statuses. Results The NACT cohort comprised 166 patients (53.6% underwent lymphadenectomy), of whom 58 presented with MLNs (the MLN group) and 108 did not (the NLN group). Among those who underwent lymphadenectomy, a median of 24 pelvic lymph nodes and 13 para-aortic lymph nodes were resected. The MLN group was significantly associated with inferior progression-free survival (PFS) and time to platinum-resistant recurrence (TTPR), even when adjusted by multivariate models. The hazard ratio (95% confidence interval) was 1.90 (1.06–3.41) for the multivariate PFS analysis and 2.50 (1.22–5.13) for the multivariate TTPR analysis. For the PDS cohort (143 patients, 68.5% underwent lymphadenectomy), a median of 25 pelvic lymph nodes and 14 para-aortic lymph nodes were resected. The MLN group (66 patients) manifested non-inferior PFS and TTPR outcomes compared to the NLN group (77 patients). Conclusions MLNs may have a negative impact on the prognosis of patients receiving NACT. For such patients, PDS is a preferred choice to delay recurrence and platinum resistance. |
| format | Article |
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| institution | DOAJ |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-05-01 |
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| series | BMC Cancer |
| spelling | doaj-art-b03d96edb9df48c58dba925a72ae41cb2025-08-20T03:09:19ZengBMCBMC Cancer1471-24072025-05-0125111210.1186/s12885-025-14237-2Patients with macroscopic lymph node metastasis expect poor prognosis after neoadjuvant chemotherapy in advanced ovarian cancer: a retrospective cohort study based on a single gynecological teamWen Guo0Jie Yin1Yu Gu2Yin Shan3Wei Wang4Yan Li5Meng Qin6Jiayu Chen7Ying Jin8Lingya Pan9Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Objective To investigate the prognostic impact of metastatic lymph nodes (MLNs) on advanced epithelial ovarian cancer (EOC) patients receiving neoadjuvant chemotherapy (NACT). Methods This was a retrospective cohort study using data from patients managed by a single gynecological team between June 2012 and June 2023. Among EOC patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC or IV disease, patients who received NACT and who underwent complete cytoreduction during interval debulking surgery were included (the NACT cohort), together with patients who received primary debulking surgery (PDS, including those with both complete and incomplete cytoreduction). Clinically suspicious lymph nodes at diagnosis and/or debulking surgeries were resected. Differences in terms of clinicopathological features, survival profiles, and recurrence patterns were analyzed between groups with different lymph node statuses. Results The NACT cohort comprised 166 patients (53.6% underwent lymphadenectomy), of whom 58 presented with MLNs (the MLN group) and 108 did not (the NLN group). Among those who underwent lymphadenectomy, a median of 24 pelvic lymph nodes and 13 para-aortic lymph nodes were resected. The MLN group was significantly associated with inferior progression-free survival (PFS) and time to platinum-resistant recurrence (TTPR), even when adjusted by multivariate models. The hazard ratio (95% confidence interval) was 1.90 (1.06–3.41) for the multivariate PFS analysis and 2.50 (1.22–5.13) for the multivariate TTPR analysis. For the PDS cohort (143 patients, 68.5% underwent lymphadenectomy), a median of 25 pelvic lymph nodes and 14 para-aortic lymph nodes were resected. The MLN group (66 patients) manifested non-inferior PFS and TTPR outcomes compared to the NLN group (77 patients). Conclusions MLNs may have a negative impact on the prognosis of patients receiving NACT. For such patients, PDS is a preferred choice to delay recurrence and platinum resistance.https://doi.org/10.1186/s12885-025-14237-2Advanced ovarian cancerNeoadjuvant chemotherapyLymph node metastasisPrognosis |
| spellingShingle | Wen Guo Jie Yin Yu Gu Yin Shan Wei Wang Yan Li Meng Qin Jiayu Chen Ying Jin Lingya Pan Patients with macroscopic lymph node metastasis expect poor prognosis after neoadjuvant chemotherapy in advanced ovarian cancer: a retrospective cohort study based on a single gynecological team BMC Cancer Advanced ovarian cancer Neoadjuvant chemotherapy Lymph node metastasis Prognosis |
| title | Patients with macroscopic lymph node metastasis expect poor prognosis after neoadjuvant chemotherapy in advanced ovarian cancer: a retrospective cohort study based on a single gynecological team |
| title_full | Patients with macroscopic lymph node metastasis expect poor prognosis after neoadjuvant chemotherapy in advanced ovarian cancer: a retrospective cohort study based on a single gynecological team |
| title_fullStr | Patients with macroscopic lymph node metastasis expect poor prognosis after neoadjuvant chemotherapy in advanced ovarian cancer: a retrospective cohort study based on a single gynecological team |
| title_full_unstemmed | Patients with macroscopic lymph node metastasis expect poor prognosis after neoadjuvant chemotherapy in advanced ovarian cancer: a retrospective cohort study based on a single gynecological team |
| title_short | Patients with macroscopic lymph node metastasis expect poor prognosis after neoadjuvant chemotherapy in advanced ovarian cancer: a retrospective cohort study based on a single gynecological team |
| title_sort | patients with macroscopic lymph node metastasis expect poor prognosis after neoadjuvant chemotherapy in advanced ovarian cancer a retrospective cohort study based on a single gynecological team |
| topic | Advanced ovarian cancer Neoadjuvant chemotherapy Lymph node metastasis Prognosis |
| url | https://doi.org/10.1186/s12885-025-14237-2 |
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