The Influence of Cyst Emptying, Lymph Node Resection and Chemotherapy on Survival in Stage IA and IC1 Epithelial Ovarian Cancer

Anticancer Res. 2016 Oct;36(10):5373-5379. doi: 10.21873/anticanres.11111.

Abstract

Aim: To determine if survival in stage I ovarian cancer is influenced by cyst emptying, lymph node resection and chemotherapy.

Patients and methods: A survival analysis of 607 patients with ovarian cancer in stage IA, IA with cyst emptying (IAempty) and IC1 was performed.

Results: There was no difference in five-year survival between IA (87%) and IC1 (87%) (p=0.899), between IA and IAempty (86%) (p=0.500) nor between IA+IAempty (87%) and IC1 without IAempty (84%) (p=0.527). Five-year survival rate (5YSR) was significantly higher after lymph node resection in stage IA (94% vs. 85%; p=0.01) and IA+IC1 (93% vs. 85%; p=0.004). In multivariate analysis, lymph node resection improved prognosis significantly for all sub-stages, whereas stage and chemotherapy did not affect survival.

Conclusion: In stage IA ovarian cancer, controlled cyst emptying without spill does not worsen prognosis. Lymph node resection is associated with improved survival in stage IA and IC1. Chemotherapy should only be offered where randomized controlled studies have shown a benefit.

Keywords: Ovarian cancer; cyst rupture; cyst spill; lymph node; stage I; staging; survival.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Ovarian Epithelial
  • Female
  • Humans
  • Lymph Node Excision*
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms, Glandular and Epithelial / drug therapy*
  • Neoplasms, Glandular and Epithelial / surgery*
  • Ovarian Cysts / surgery*
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / surgery*
  • Survival Rate
  • Young Adult