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Mixed Results for Lymph-Removing Ovarian Cancer Surgery

It slowed disease progression, but didn't affect overall survival

WEDNESDAY, April 20, 2005 (HealthDay News) -- For women battling ovarian cancer, removal of certain lymph nodes does not improve overall five-year survival, researchers report.

The procedure, called systemic lymphadenectomy, may slow progression of the disease for some patients, however.

The Italian study included 427 women with advanced ovarian cancer who had either primary tumor-reducing surgery followed by lymphadenectomy -- removal of the aortic and pelvic lymph nodes -- or surgery alone. The patients were tracked for an average of nearly five years.

The procedure did seem to slow disease progression: Patients who had lymphadenectomy had a five-year progression-free survival rate of 31.2 percent, the researchers note, compared with 21.6 percent for those who had only enlarged nodes removed. The lymphadenectomy group also had a longer duration of progression-free survival -- 29.4 months versus 22.4 months.

However, both groups had similar five-year overall survival rates and median overall survival duration.

The study authors note that the operations took longer for the women treated with lymphadenectomy and more of them required blood transfusions.

Reporting in the April 20 issue of the Journal of the National Cancer Institute, researchers at "La Sapienza" University, in Rome, say that adding this extra lymph node removal to standard surgery "prolonged progression-free survival, which, in turn, may have an important impact on the quality of life of patients with advanced ovarian cancer." They also speculate that that any added survival benefit of systemic lymphadenectomy might be hidden by the benefit of other powerful chemotherapies the patients received.

However, in an editorial accompanying the study, Dr. Setsuko Chambers of Arizona Cancer Center, Tucson, said that "as disappointing as the result may be to some gynecologic oncologists, the body of evidence does not favor including systematic lymphadenectomy" in the treatment of advanced ovarian cancer.

More information

The American Cancer Society has more about ovarian cancer.

SOURCE: Journal of the National Cancer Institute, news release, April 19, 2005
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