Lymph node evaluation and nodal metastasis prediction in epithelial ovarian cancers: A retrospective study.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-09-04 DOI:10.4274/tjod.galenos.2024.50980

Pallavi Verma, Anupama Bahadur, Shalini Rajaram, Rajkumar Kottayasamy Seenivasagam, Jaya Chaturvedi, Rajlaxmi Mundhra, Amrita Gaurav, Shalinee Rao, Ipshita Sahoo, Ayush Heda

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Abstract

Objective: To identify consensus regarding lymph node (LN) evaluation in epithelial ovarian cancer (EOC). The objective of the present study was to evaluate surgico-pathological findings, LN involvement, and the prediction of LN metastasis via preoperative imaging and intraoperative assessment in women with EOC.

Materials and methods: Women with EOC who underwent cytoreductive surgery (CRS) between Jan 2019 to June 2022 were included. The distribution of histology, stage, and LN metastasis was studied. The predictive value of serum cancer antigen (CA)-125, instead of and radiologically and surgically enlarged LNs with final LN histopathology was studied.

Results: A total of 96 women with EOCs underwent CRS. Fifty women (52%) underwent primary CRS and 46 women (48%) underwent interval CRS. Seventy-five women (78.13%) with EOC underwent pelvic and/or para-aortic lymphadenectomy, out of which 23 (30.67%) were histologically positive. High-grade serous carcinoma was the commonest (n=55, 73.33%) histology. The majority of women, 56 (74.67%) were stage III or IV at presentation. Complete cytoreduction was achieved in 59 (78.66%) patients. The receiver operating characteristics curve showed a cutoff for CA-125 of 1360 U/mL (area under the curve 0.702, p=0.002) for LN metastases. Both radiologically and surgically enlarged LNs significantly predicted LN metastasis on histopathology (p=0.02 and 0.006 respectively). The combined sensitivity, specificity, positive predictive value and negative predictive value of both contrast enhanced computed tomography (CECT) and surgically enlarged LNs were 78.26%, 57.69%, 45%, and 85.71%, respectively.

Conclusion: Serous histology, high-grade tumors, highCA-125 levels, and suspicious LNs on CECT or during surgery were significantly associated with LN metastasis. However, considering the false-negative rate of 21.74%, the combination of radiologically and surgically enlarged LNs cannot be used as the sole surrogate marker for lymphadenectomy.

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上皮性卵巢癌的淋巴结评估和结节转移预测：回顾性研究

目的：确定有关上皮性卵巢癌（EOC）淋巴结（LN）评估的共识：确定有关上皮性卵巢癌（EOC）淋巴结（LN）评估的共识。本研究旨在评估手术病理结果、LN受累情况以及通过术前成像和术中评估预测EOC女性患者的LN转移情况：纳入2019年1月至2022年6月期间接受细胞减灭术（CRS）的EOC女性患者。研究了组织学、分期和LN转移的分布情况。研究了血清癌抗原（CA）-125，而非放射学和手术增大的LN与最终LN组织病理学的预测价值：共有 96 名女性 EOC 患者接受了 CRS。结果：共有 96 名 EOCs 妇女接受了 CRS，其中 50 名妇女（52%）接受了初级 CRS，46 名妇女（48%）接受了间歇性 CRS。75名女性（78.13%）EOC患者接受了盆腔和/或主动脉旁淋巴结切除术，其中23人（30.67%）组织学结果呈阳性。高分化浆液性癌是最常见的组织学类型（55 人，占 73.33%）。大多数妇女（56 人，占 74.67%）发病时处于 III 期或 IV 期。59名患者（78.66%）实现了完全细胞减灭术。接收器操作特征曲线显示，CA-125 的临界值为 1360 U/mL（曲线下面积为 0.702，P=0.002），LN 转移的临界值为 1360 U/mL。放射学和手术增大的 LN 均可显著预测组织病理学上的 LN 转移（分别为 p=0.02 和 0.006）。对比增强计算机断层扫描（CECT）和手术增大的LNs的综合敏感性、特异性、阳性预测值和阴性预测值分别为78.26%、57.69%、45%和85.71%：血清组织学、高级别肿瘤、高CA-125水平以及CECT或手术中的可疑LN与LN转移显著相关。然而，考虑到21.74%的假阴性率，影像学和手术中肿大LN的组合不能作为淋巴结切除的唯一替代指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.