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Salvage lymphadenectomy in recurrent ovarian cancer patients: Analysis of clinical outcome and BRCA1/2 gene mutational status

  • V Gallotta
    Correspondence
    Corresponding author. Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, L.go A. Gemelli, 8, 00168, Rome, Italy.
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, Roma, Italy
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  • M Bruno
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, Roma, Italy

    Università Cattolica Del Sacro Cuore, Roma, Italy
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  • C Conte
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, Roma, Italy
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  • MT Giudice
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, Roma, Italy

    Università Cattolica Del Sacro Cuore, Roma, Italy
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  • F Davià
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, Roma, Italy

    Università Cattolica Del Sacro Cuore, Roma, Italy
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  • F Moro
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, Roma, Italy
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  • GF Zannoni
    Affiliations
    Università Cattolica Del Sacro Cuore, Roma, Italy

    Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Gineco-patologia e Patologia Mammaria, Roma, Italy
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  • A Fagotti
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, Roma, Italy

    Università Cattolica Del Sacro Cuore, Roma, Italy
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  • M De Bonis
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Polo Scienze per Immagini, di Laboratorio e Infettivologiche, Roma, Italy
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  • E Capoluongo
    Affiliations
    Università Federico II-CEINGE, Biotecnologie Avanzate, Napoli, Italy
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  • G Scambia
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, Roma, Italy

    Università Cattolica Del Sacro Cuore, Roma, Italy
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  • G Ferrandina
    Affiliations
    Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC di Ginecologia Oncologica, Roma, Italy

    Università Cattolica Del Sacro Cuore, Roma, Italy
    Search for articles by this author
Published:February 06, 2020DOI:https://doi.org/10.1016/j.ejso.2020.01.035

      Abstract

      Objective

      This study is aimed to analyze the clinical outcome of recurrent ovarian cancer patients bearing isolated lymph-node recurrence (ILNR) who underwent salvage lymphadenectomy (SL). The prognostic role of clinicopathological variables and the mutational status of BRCA1/2 have also been investigated.

      Methods

      This retrospective, single-institutional study included women with platinum-sensitive lymph node recurrence underwent to SL between June 2008 and June 2018. Univariate and multivariate analysis was performed to evaluate the impact of clinical parameters, and BRCA1/2 mutational status on post salvage lymphadenectomy progression-free survival (PSL-PFS).

      Results

      As of June 2019, the median follow-up after SL was 30 months, and the relapse has been documented in 48 (56.5%) patients. In the whole series, the median PSL-PFS was 21 months, and the 3-year PSL-PFS was 36.7%. The median PSL-PFS, according to patients with ILNR (N = 71) versus patients with lymph-nodes and other sites of disease (N = 14), was 27 months versus 12 months, respectively.
      Univariate analysis of variables conditioning PSL-PFS showed that platinum-free interval (PFI) ≥12 months, normal Ca125 serum levels, and number of metastatic lymph-nodes ≤3 played a statistically significant favorable role. In multivariate analysis, PFI duration ≥12 months and the number of metastatic lymph nodes ≤3 were shown to keep their favorable, independent prognostic value on PSL-PFS.

      Conclusions

      In the context of SL, the patients with long PFI and low metastatic lymph node numbers at ILNR diagnosis have the best outcome. The BRCA mutational status seems not associated with clinical variables and PSL-PFS, differently from other sites of disease in ROC patients.

      Keywords

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