Highlights
- •The data is limited to guide prognosis and management for inguinal lymph node metastasis (ILNM) in newly diagnosed EOC
- •27.8% of the ILNM cohort had a mutation in BRCA1, BRCA2, or BRIP1
- •ILNM did not portend a worse clinical outcome compared to all Stage III/IV and Stage IVB patients
- •Resection to no gross residual disease was associated with improved PFS in the ILNM cohort
Abstract
Objective(s)
To assess incidence and oncologic outcomes in women with advanced epithelial ovarian
cancer (EOC) with inguinal lymph node metastasis (ILNM) at diagnosis.
Methods
An IRB-approved, retrospective single-institution cohort study was performed in women
with stage III/IV EOC from 2009 to 2017. Patients with inguinal lymphadenopathy (defined
as >1 cm in short axis) clinically or radiographically were identified. The impact
of ILNM on progression-free survival (PFS) and overall survival (OS) were assessed.
Results
Of the 562 women with advanced EOC, 18 (3.2%) had ILNM at diagnosis, accounting for
25.7% of all patients with stage IVB disease (n = 70). Five patients (27.7%) had a known genetic predisposition for EOC, including
BRCA1 (11.1%, n = 2), BRCA2 (11.1%, n = 2) and BRIP1 (5.6%, n = 1). The majority of patients underwent optimal primary cytoreductive surgery (CRS),
including debulking of inguinal nodal metastasis (83.3%, n = 15), with 50% (n = 9) having no gross residual disease after surgery. There was no difference in PFS
(19.9 vs. 19.9 vs. 17.2 months, p = 0.84) or OS (137.2 vs. 52.9 vs. 67.6 months, p = 0.29) in women with stage III/IV with ILNM, stage III/IV without ILNM, and stage
IVB disease without ILNM, respectively. Progression-free survival was improved in
women with ILNM who underwent an optimal resection to no macroscopic disease vs. non-optimal
resection (27.4 vs. 14.3 months, p = 0.019). Median overall survival at the time of analysis did not reach statistical
significance (137.2 vs. 57.3 months, p = 0.24).
Conclusion(s)
In this retrospective cohort study, 3.2% of women with advanced EOC presented with
ILNM at diagnosis. Although ILNM did not portend worse clinical outcomes compared
to all Stage III/IV and Stage IVB patients, respectively, resection to no gross residual
disease was associated with improved PFS.
Keywords
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Article info
Publication history
Published online: March 08, 2022
Accepted:
January 23,
2022
Received in revised form:
January 13,
2022
Received:
November 2,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
