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Prognostic Relevance of Celiac Lymph Node Involvement in Ovarian Cancer

Martínez, Alejandra MD*; Pomel, Cristophe PhD; Filleron, Thomas PhD; De Cuypere, Marjolein MD*; Mery, Eliane MD§; Querleu, Denis PhD*; Gladieff, Laurance MD; Poilblanc, Mathieu MD*; Ferron, Gwénaël MD*

International Journal of Gynecological Cancer: January 2014 - Volume 24 - Issue 1 - p 48–53
doi: 10.1097/IGC.0000000000000041
Ovarian Cancer

Objective The aim of the study was to report on the oncologic outcome of the disease spread to celiac lymph nodes (CLNs) in advanced-stage ovarian cancer patients.

Methods All patients who had CLN resection as part of their cytoreductive surgery for epithelial ovarian, fallopian, or primary peritoneal cancer were identified. Patient demographic data with particular emphasis on operative records to detail the extent and distribution of the disease spread, lymphadenectomy procedures, pathologic data, and follow-up data were included.

Results The median follow-up was 26.3 months. The median overall survival values in the group with positive CLNs and in the group with negative CLNs were 26.9 months and 40.04 months, respectively. The median progression-free survival values in the group with metastatic CLNs and in the group with negative CLNs were 8.8 months and 20.24 months, respectively (P = 0.053). Positive CLNs were associated with progression during or within 6 months after the completion of chemotherapy (P = 0.0044). Tumor burden and extensive disease distribution were significantly associated with poor progression-free survival, short-term progression, and overall survival. In multivariate analysis, only the CLN status was independently associated with short-term progression.

Conclusions Disease in the CLN is a marker of disease severity, which is associated to a high-risk group of patients with presumed adverse tumor biology, increased risk of lymph node progression, and worst oncologic outcome.

*Department of Surgical Oncology, Claudius Regaud Comprehensive Cancer Center; †Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Center, Clermont-Ferrand, France; Departments of ‡Biostatistics, §Pathology, and ∥Medical Oncology, Claudius Regaud Comprehensive Cancer Center, Toulouse, France.

Address correspondence and reprint requests to Alejandra Martínez, MD, Department of Surgical Oncology, Claudius Regaud Comprehensive Cancer Center, 20-24, Rue Pont-Saint-Pierre, 31052 Toulouse, France. E-mail:

The authors declare no conflicts of interest.

Received May 30, 2013

Accepted October 17, 2013

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.