Rahimpour Elham, Niroomand Behnaz, Kalatehjari Maryam, Shahbakhti Fatemeh, Bahardoust Mansour, Goodarzy Babak, Majdolashrafi Fatemeh, Ghorbanzade Sara, Tizmaghz Adnan
Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Indian J Surg Oncol. 2025 Apr;16(2):536-542. doi: 10.1007/s13193-024-02077-8. Epub 2024 Sep 27.
The effect of the number of negative lymph nodes (NLNs) removed on the overall survival (OS) and recurrence rate of ovarian cancer (OC) patients has not been investigated. This study aimed to investigate the effect of the number of NLNs removed on OC patients' survival and recurrence rate after primary surgery. In this multi-center cohort study, the medical profile of 504 OC patients (mean age 55.21 years and mean follow-up 78.5 ± 28.4 months) who underwent primary surgery between 2011 and 2021 in gynecological tumor surgery centers affiliated with Iran and Shahid Beheshti Universities of Medical Sciences, Tehran, Iran, was retrospectively examined. Based on the number of NLNs removed, patients were divided into four groups, including 0-9, 10-19, 20-30, and > 30 NLNs, including 152, 169, 124, and 59 OC patients, respectively. The 5-year survival was 49.1%. The median survival was 61 months. The RFS and OS were significantly better in patients with more than 30 NLNs removed compared to other groups. The multivariable analysis showed that the OS rate was significantly better in patients with the number of NLNs removed ≥ 20 compared to < 20 (HR, 1.88; 95% CI 1.15-2.62; , 0.001). Also, age, FIGO stage, presence of metastasis, adjuvant therapy, and tumor pathological differentiation were significantly related to the OS of OC patients ( < 0.05). Paying attention to the number of NLNs removed during primary surgery can be a key factor in improving the OS rate of OC patients.
切除的阴性淋巴结数量对卵巢癌（OC）患者总生存期（OS）和复发率的影响尚未得到研究。本研究旨在探讨切除的阴性淋巴结数量对OC患者初次手术后生存期和复发率的影响。在这项多中心队列研究中，回顾性分析了2011年至2021年间在伊朗德黑兰伊朗医科大学和沙希德·贝赫什提医科大学附属妇科肿瘤手术中心接受初次手术的504例OC患者的医学资料（平均年龄55.21岁，平均随访78.5±28.4个月）。根据切除的阴性淋巴结数量，患者被分为四组，包括0 - 9个、10 - 19个、20 - 30个和>30个阴性淋巴结，分别有152例、169例、124例和59例OC患者。5年生存率为49.1%。中位生存期为61个月。与其他组相比，切除超过30个阴性淋巴结的患者无复发生存期（RFS）和总生存期明显更好。多变量分析显示，切除阴性淋巴结数量≥20个的患者与<20个的患者相比，总生存率明显更好（风险比[HR]，1.88；95%置信区间[CI] 1.15 - 2.62；P = 0.001）。此外，年龄、国际妇产科联盟（FIGO）分期、转移情况、辅助治疗和肿瘤病理分化与OC患者的总生存期显著相关（P < 0.05）。在初次手术时关注切除的阴性淋巴结数量可能是提高OC患者总生存率的关键因素。
