OBJECTIVE: Women diagnosed with ovarian tumors of low malignant potential ha ve an excellent prognosis. Because few will receive adjuvant therapy, the benefit of surgical staging has recently been challenged. The purp...OBJECTIVE: Women diagnosed with ovarian tumors of low malignant potential ha ve an excellent prognosis. Because few will receive adjuvant therapy, the benefit of surgical staging has recently been challenged. The purpose of this study was to compare the outcome of surgically staged patients with low malignant potentia l tumors with those who were not staged. METHODS: Between 1984 and 2003, all wom en with ovarian low malignant potential tumors were identified at 3 institutions . Data were extracted from clinical records. RESULTS: One hundred eighty-three (74%) of 248 women were surgically staged. Forty of 183 staged patients had cli nically obvious extraovarian disease. Forty (28%) of the remaining 143 women wi th disease apparently confined to the ovary were upstaged. Cytologic washings we re positive in 28 cases, 10 had microscopic implants detected by peritoneal or o mental biopsy, and 2 were upstaged to stage IIIC solely on the basis of nodal me tastases. One hundred eighteen women underwent pelvic node dissection (median: 5 nodes), and 86 underwent paraaortic node dissection (median: 2 nodes). Overall, 9 (1%) metastases were detected in 832 submitted pelvic nodes. All 314 paraaor tic nodes were negative. Intraoperative blood loss (P < .001) and length of hosp ital stay (P < .001) were increased in women without gross disease who were surg ically staged. Eight (3%) of 248 patients received adjuvant platinum-based che motherapy, but neither of the women upstaged to IIIC based on the results of the ir nodal dissection were treated. Fifteen (6%) recurrences developed and 1 (0.4 %) death occurred after a median follow-up of 28 (range, 1-208) months. CONCL USION: Routine pelvic and paraaortic lymph node dissection is not necessary in t he majority of women with ovarian low malignant potential rumors.展开更多
文摘OBJECTIVE: Women diagnosed with ovarian tumors of low malignant potential ha ve an excellent prognosis. Because few will receive adjuvant therapy, the benefit of surgical staging has recently been challenged. The purpose of this study was to compare the outcome of surgically staged patients with low malignant potentia l tumors with those who were not staged. METHODS: Between 1984 and 2003, all wom en with ovarian low malignant potential tumors were identified at 3 institutions . Data were extracted from clinical records. RESULTS: One hundred eighty-three (74%) of 248 women were surgically staged. Forty of 183 staged patients had cli nically obvious extraovarian disease. Forty (28%) of the remaining 143 women wi th disease apparently confined to the ovary were upstaged. Cytologic washings we re positive in 28 cases, 10 had microscopic implants detected by peritoneal or o mental biopsy, and 2 were upstaged to stage IIIC solely on the basis of nodal me tastases. One hundred eighteen women underwent pelvic node dissection (median: 5 nodes), and 86 underwent paraaortic node dissection (median: 2 nodes). Overall, 9 (1%) metastases were detected in 832 submitted pelvic nodes. All 314 paraaor tic nodes were negative. Intraoperative blood loss (P < .001) and length of hosp ital stay (P < .001) were increased in women without gross disease who were surg ically staged. Eight (3%) of 248 patients received adjuvant platinum-based che motherapy, but neither of the women upstaged to IIIC based on the results of the ir nodal dissection were treated. Fifteen (6%) recurrences developed and 1 (0.4 %) death occurred after a median follow-up of 28 (range, 1-208) months. CONCL USION: Routine pelvic and paraaortic lymph node dissection is not necessary in t he majority of women with ovarian low malignant potential rumors.
