The prognostic impact of the ratio of positive lymph nodes on survival of epithelial ovarian cancer patients
Version of Record online: 16 JAN 2011
Copyright © 2011 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 103, Issue 7, pages 724–729, 1 June 2011
How to Cite
Mahdi, H., Thrall, M., Kumar, S., Hanna, R., Seward, S., Lockhart, D., Morris, R. T., Swensen, R. and Munkarah, A. R. (2011), The prognostic impact of the ratio of positive lymph nodes on survival of epithelial ovarian cancer patients. J. Surg. Oncol., 103: 724–729. doi: 10.1002/jso.21869
- Issue online: 26 APR 2011
- Version of Record online: 16 JAN 2011
- Manuscript Accepted: 21 DEC 2010
- Manuscript Received: 20 OCT 2010
- lymph node ratio;
- positive lymph nodes;
- ovarian cancer
Background and Objectives
To study the prognostic significance of ratio of positive to examined lymph nodes (LNR) on survival of patients with node positive epithelial ovarian cancer (NPEOC).
Data were obtained from Surveillance, Epidemiology, and End Results Program (SEER) from 1988 to 2006, and analyzed using Kaplan–Meier survival and Cox regression proportional hazard methods. Patients were divided into: stage IIIC group 1 (no macroscopic peritoneal disease), stage IIIC group 2 (macroscopic peritoneal disease), and stage IV.
A total of 6,310 women were included. The 5-year survival for stage IIIC groups 1, 2, and stage IV was 55.4%, 35.5%, and 20.3%, respectively (P < 0.001). Increasing LNR (<10%, 10–50%, and >50%) was associated with decreased survival from 51.5% to 38.1% to 27.0%, respectively, (P < 0.001). On multivariate analysis, LNR was an independent prognostic factor for survival after adjusting for extent of peritoneal disease, stage, grade, race, age, extent of lymphadenectomy and absolute number of positive nodes.
The impact of increasing LNR was strongly related to survival, especially in patients with no macroscopic peritoneal disease. Stratification of this subpopulation of node positive EOC based on nodal burden provides a significant prognostic value that may be considered in future staging and aid in management decisions. J. Surg. Oncol. 2011;103:724–729. © 2011 Wiley-Liss, Inc.