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  • Title: Isolated lymph node relapse of epithelial ovarian carcinoma: outcomes and prognostic factors.
    Author: Blanchard P, Plantade A, Pagès C, Afchain P, Louvet C, Tournigand C, de Gramont A.
    Journal: Gynecol Oncol; 2007 Jan; 104(1):41-5. PubMed ID: 16952391.
    Abstract:
    BACKGROUND: Relapses of epithelial ovarian carcinoma (EOC) have a poor prognosis. Isolated lymph node relapses (ILNR) are considered of relatively good prognosis with intensive therapy. METHODS: This retrospective study aimed to describe incidence, characteristics, outcomes and prognostic factors of ILNR treated over 15 years. RESULTS: Twenty-seven patients (4.2%) experienced an ILNR among 640 patients. Median age was 59 years, tumour stages included stage I (n=4), II (n=5), III (n=15) and IV (n=3). After initial optimal treatment, median progression-free survival (PFS) was 26 months. Sites of relapse were retroperitoneum (n=15), left supraclavicular (n=7), mediastinum (n=4), iliac (n=4) and inguinal (n=3). ILNR locations were unique in 63% of patients (n=17) and multiple in 37% (n=10). Treatment modalities were surgery in eight patients (30%), chemotherapy in 15 (55%) and radiotherapy in 5 patients (18%), alone or in combination. Seven patients without tumour-related symptoms (26%) were not treated. Median overall survival (OS) after ILNR was 26 months. Median OS from initial diagnosis was 68 months. 25% of patients had a very long survival (>100 months), independent of their initial staging or PFS. There was no difference in 2-year survival after ILNR between the groups of early relapse (before 24 months) and late relapse (after 24 months). In the seven non-treated patients, median OS was 91 months. CONCLUSION: ILNR is a rare event in EOC. Time to relapse may not have its usual prognostic value. Immediate or delayed therapy should be discussed in case of asymptomatic ILNR.
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