Proportion of positive lymph nodes in relation to survival of patients with epithelial ovarian cancer in advanced clinical stages in the National Medical Center "20 de Noviembre.

Abstract

e17601 Background: Ovarian cancer is a public health problem. The fourth most frequent gynecological neoplasm and the second with the highest mortality, which can be attributed to the fact that 80% of cases are diagnosed in advanced stages. Methods: Retrospective study. To evaluate the relationship of the proportion of positive lymph nodes with the survival of patients with epithelial ovarian cancer in advanced stages operated on at the "20 de Noviembre" National Medical Center in the period seven years. Results: Serous papillary cystadenocarcinoma in 91.3% cases. Clinical stage IIIC 12 of the 23 cases. 82.6% received neoadjuvant chemotherapy. The average surgical time 262 minutes, average bleeding 511.5 ml. 87% received adjuvant chemotherapy. The average number of lymph nodes resected 13.1 nodes and 2.3 positive nodes. Survival a median of 84 months was reported in group 1 of positive lymph node proportions, in group 3 a median of 38 months was reported. In group 2, no median was obtained, but a mean of 26.7 months was estimated. Overall survival had a median of 58 months. The result of the Kaplan Meier test through log Rank and Breslow reported a p<0.05, showing differences in the behavior of the survival curves of the 3 groups. The means for the disease-free period in patients with 10 or fewer resected nodes was 17.18 months, for the group with more than 10 resected nodes the observed mean was 50.2 months. The findings of this study allow observing the proportion of positive lymph nodes as an independent variable to predict the risk of malignancy, observing a marked tendency to death in group 3 (more than 50% of positive nodes) and a better survival in group 3. group 1(0-25%). Statistical significance was observed in the overall survival curves, observing key differences in the behavior of each group. These differences cannot be demonstrated when calculating the OR for each group, because despite the fact that the risks are statistically significant, the confidence intervals are below and ahead of the unit. Conclusions: This is the first study to evaluate the effect of the proportion of positive lymph nodes in patients with advanced stages of epithelial ovarian cancer in a Latin American population. We can find an impact on overall survival in patients with a proportion greater than 50%, observing decreased survival and the inverse effect on the proportion less than 25%, as had already been shown in previous studies. No impact of the proportion of lymph nodes on the disease-free period was found and the directly proportional relationship between the number of nodes resected in lymphadenectomy and the disease-free period was corroborated.