16 The effect of chemotherapy on lymph node metastases in ovarian cancer
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Cited by (54)
Neo-adjuvant chemotherapy does not reduce surgical complexity nor the accuracy of intra-operative visual assessment of disease in advanced ovarian cancer
2023, European Journal of Surgical OncologySurvival outcomes of ovarian cancer patients treated with secondary cytoreductive surgery for isolated lymph node recurrence: A systematic review of the literature
2019, International Journal of SurgeryCitation Excerpt :In 2004 Morice et al. observed that lymph node metastases tend to be chemoresistant and this may partially explain the results of this systematic review [27]. An earlier report also suggested that platinum based chemotherapy has a small effect on lymph node tumour deposits [28]. Given this information, one could, assume that lymphadenectomy could improve survival outcomes of patients with ILNR by simply removing the chemoresistant residual disease.
The role of pelvic and aortic lymphadenectomy at second look surgery in apparent early stage ovarian cancer after inadequate surgical staging followed by adjuvant chemotherapy
2014, Gynecologic OncologyCitation Excerpt :Second look surgery for ovarian cancer was introduced in clinical practice to accurately assess the pathological response in women with apparent clinical complete response to first line chemotherapy, to perform a debulking of persistent disease and to select women who might benefit from a second line chemotherapeutic treatment [14–18,28]. In this context SAPL at second look surgery was generally performed to remove eventual resistant clones of tumor cells in the pelvic or aortic nodes, undetectable by clinical evaluation or palpation or by imaging [27–30]. Only limited data on the value of lymphadenectomy at second look surgery are available, showing that the risk of nodal involvement is mainly related with stage, presence of residual tumor at primary surgery and persistent peritoneal tumor at second look [19–21].
Prognostic factors for and prognostic value of mesenteric lymph node involvement in advanced-stage ovarian cancer
2012, European Journal of Surgical OncologyCitation Excerpt :This is probably unlikely since the rate of positive mesenteric nodes was similar in patients treated initially or after neoadjuvant chemotherapy (Table 1). Furthermore, other reports suggest that the rate of nodal involvement is similar whether patients receive chemotherapy or not before debulking surgery.20–26 Whatever the factors likely to influence the risk of mesenteric node involvement, should such a discovery modify the preoperative strategy, as suggested in the conclusion of the papers reported by O’Hanlan et al. and Silani et al.15,17 ?
The clinical outcome of epithelial ovarian cancer patients with apparently isolated lymph node recurrence: A multicenter retrospective Italian study
2010, Gynecologic OncologyCitation Excerpt :For instance in the series of Blanchard et al. [21], the treatment of 20 patients with isolated nodal recurrence consisted of chemotherapy alone in 8 patients, surgery followed by chemotherapy in 5, chemo-radiation in 2, surgery alone in 2, irradiation alone in 2 and surgery followed by irradiation in one patient. A complete response to chemotherapy was obtained in 55% of the patients, which contradicted previous studies suggesting that nodal metastases from epithelial ovarian cancer are chemo-resistant lesions [30–34]. Some authors have recommended radiotherapy (45–60 Gy), but it might not be effective in treating bulky nodes [21,35].
Role of complete lymphadenectomy in endometrioid uterine cancer
2007, Lancet OncologyCitation Excerpt :Additionally, an extensive lymph-node resection could lead to an improvement in survival by removing micrometastatic or macrometastatic disease within the lymph nodes, which might become resistant to chemotherapy. Previous studies on patients with ovarian cancer who underwent chemotherapy followed by postchemotherapy surgical restaging showed that 33·3–65·3% of patients with advanced-stage disease had residual disease in the retroperitoneal lymph nodes.78,79 This finding suggests that chemotherapy has a minimum effect on tumour deposits in the lymph nodes.