Prognostic impact of suspicious extraabdominal lymph nodes on patient survival in advanced ovarian cancer

To evaluate the clinical impact of suspicious extra-abdominal lymph nodes (EALNs) identified preoperatively on CT and/or PET/CT images in advanced ovarian cancer. A retrospective study was conducted with 122 patients diagnosed with stage III or IV ovarian cancer with preoperative CT and/or PET/CT im...

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Veröffentlicht in:PloS one 2024-05, Vol.19 (5), p.e0299205-e0299205
Hauptverfasser: Park, Kena, Kwon, Ji Young, Song, Jeong Min, Pyeon, Seung Yeon, Lee, Seon Hwa, Chung, Young Shin, Lee, Jong-Min
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Kwon, Ji Young
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Lee, Seon Hwa
Chung, Young Shin
Lee, Jong-Min
description To evaluate the clinical impact of suspicious extra-abdominal lymph nodes (EALNs) identified preoperatively on CT and/or PET/CT images in advanced ovarian cancer. A retrospective study was conducted with 122 patients diagnosed with stage III or IV ovarian cancer with preoperative CT and/or PET/CT images from 2006 to 2022. Imaging studies were evaluated for the presence, size and location of suspicious EALNs. Suspicious lymph node enlargement was defined by a cut-off ≥5mm short-axis dimension on CT and/or lesions with maximum standardized uptake values of ≥2.5 on PET/CT. This study only included patients who did not have their EALNs surgically removed. A total 109 patients met the inclusion criteria; 36 (33%) had suspicious EALNs and were categorized as "node-positive". The median overall survival (OS) was 45.73 months for the "node-positive" and 46.50 months for the "node-negative" patients (HR 1.17, 95% CI 0.68-2.00, p = 0.579). In multivariate analysis, after adjusting for other variables selected by process of backward elimination using a significance level of p
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A retrospective study was conducted with 122 patients diagnosed with stage III or IV ovarian cancer with preoperative CT and/or PET/CT images from 2006 to 2022. Imaging studies were evaluated for the presence, size and location of suspicious EALNs. Suspicious lymph node enlargement was defined by a cut-off ≥5mm short-axis dimension on CT and/or lesions with maximum standardized uptake values of ≥2.5 on PET/CT. This study only included patients who did not have their EALNs surgically removed. A total 109 patients met the inclusion criteria; 36 (33%) had suspicious EALNs and were categorized as "node-positive". The median overall survival (OS) was 45.73 months for the "node-positive" and 46.50 months for the "node-negative" patients (HR 1.17, 95% CI 0.68-2.00, p = 0.579). In multivariate analysis, after adjusting for other variables selected by process of backward elimination using a significance level of p&lt;0.20, suspicious EALNs still showed no clinical significance on OS (aHR 1.20, 95% CI 0.67-2.13, p = 0.537) as well as progression-free survival (aHR 1.43, 95% CI 0.85-2.41, p = 0.174). Old age (aHR 2.23, 95% CI 1.28-3.89, p = 0.005) and platinum resistance (aHR 1.92, 95% CI 1.10-3.36, p = 0.023) affects adversely on OS. Suspicious EALNs did not worsen the prognosis of patients with advanced ovarian cancer. However, its impact on survival is not yet clarified. Further investigation is required to assess the clinical significance of suspicious EALNs on preoperative imaging studies.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0299205</identifier><identifier>PMID: 38805507</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abdomen ; Adult ; Aged ; Aged, 80 and over ; Biology and Life Sciences ; Cancer ; Cancer patients ; Chemotherapy ; Computed tomography ; CT imaging ; Data collection ; Development and progression ; Disease ; Female ; Humans ; Lymph nodes ; Lymph Nodes - diagnostic imaging ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Lymphatic system ; Medical imaging ; Medical prognosis ; Medicine and Health Sciences ; Middle Aged ; Multivariate analysis ; Neoplasm Staging ; Oncology, Experimental ; Ovarian cancer ; Ovarian Neoplasms - diagnosis ; Ovarian Neoplasms - diagnostic imaging ; Ovarian Neoplasms - mortality ; Ovarian Neoplasms - pathology ; Ovarian Neoplasms - surgery ; Patient outcomes ; Patients ; PET imaging ; Physical Sciences ; Platinum ; Pleural effusion ; Positron emission ; Positron Emission Tomography Computed Tomography - methods ; Prognosis ; Research and Analysis Methods ; Retrospective Studies ; Surgery ; Survival ; Tomography ; Tomography, X-Ray Computed</subject><ispartof>PloS one, 2024-05, Vol.19 (5), p.e0299205-e0299205</ispartof><rights>Copyright: © 2024 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Park et al 2024 Park et al</rights><rights>2024 Park et al. 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Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c572t-63e41fe6dce110a879a94371445132ce68df1835da2f32c132948033b96febdb3</cites><orcidid>0000-0002-7219-6386 ; 0009-0007-5775-0995 ; 0000-0001-8601-1701 ; 0000-0002-0562-5443 ; 0000-0003-4640-963X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11132458/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11132458/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38805507$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Kena</creatorcontrib><creatorcontrib>Kwon, Ji Young</creatorcontrib><creatorcontrib>Song, Jeong Min</creatorcontrib><creatorcontrib>Pyeon, Seung Yeon</creatorcontrib><creatorcontrib>Lee, Seon Hwa</creatorcontrib><creatorcontrib>Chung, Young Shin</creatorcontrib><creatorcontrib>Lee, Jong-Min</creatorcontrib><title>Prognostic impact of suspicious extraabdominal lymph nodes on patient survival in advanced ovarian cancer</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To evaluate the clinical impact of suspicious extra-abdominal lymph nodes (EALNs) identified preoperatively on CT and/or PET/CT images in advanced ovarian cancer. A retrospective study was conducted with 122 patients diagnosed with stage III or IV ovarian cancer with preoperative CT and/or PET/CT images from 2006 to 2022. Imaging studies were evaluated for the presence, size and location of suspicious EALNs. Suspicious lymph node enlargement was defined by a cut-off ≥5mm short-axis dimension on CT and/or lesions with maximum standardized uptake values of ≥2.5 on PET/CT. This study only included patients who did not have their EALNs surgically removed. A total 109 patients met the inclusion criteria; 36 (33%) had suspicious EALNs and were categorized as "node-positive". The median overall survival (OS) was 45.73 months for the "node-positive" and 46.50 months for the "node-negative" patients (HR 1.17, 95% CI 0.68-2.00, p = 0.579). In multivariate analysis, after adjusting for other variables selected by process of backward elimination using a significance level of p&lt;0.20, suspicious EALNs still showed no clinical significance on OS (aHR 1.20, 95% CI 0.67-2.13, p = 0.537) as well as progression-free survival (aHR 1.43, 95% CI 0.85-2.41, p = 0.174). Old age (aHR 2.23, 95% CI 1.28-3.89, p = 0.005) and platinum resistance (aHR 1.92, 95% CI 1.10-3.36, p = 0.023) affects adversely on OS. Suspicious EALNs did not worsen the prognosis of patients with advanced ovarian cancer. However, its impact on survival is not yet clarified. Further investigation is required to assess the clinical significance of suspicious EALNs on preoperative imaging studies.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biology and Life Sciences</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Chemotherapy</subject><subject>Computed tomography</subject><subject>CT imaging</subject><subject>Data collection</subject><subject>Development and progression</subject><subject>Disease</subject><subject>Female</subject><subject>Humans</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - diagnostic imaging</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neoplasm Staging</subject><subject>Oncology, Experimental</subject><subject>Ovarian cancer</subject><subject>Ovarian Neoplasms - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Kena</au><au>Kwon, Ji Young</au><au>Song, Jeong Min</au><au>Pyeon, Seung Yeon</au><au>Lee, Seon Hwa</au><au>Chung, Young Shin</au><au>Lee, Jong-Min</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic impact of suspicious extraabdominal lymph nodes on patient survival in advanced ovarian cancer</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-05-28</date><risdate>2024</risdate><volume>19</volume><issue>5</issue><spage>e0299205</spage><epage>e0299205</epage><pages>e0299205-e0299205</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To evaluate the clinical impact of suspicious extra-abdominal lymph nodes (EALNs) identified preoperatively on CT and/or PET/CT images in advanced ovarian cancer. A retrospective study was conducted with 122 patients diagnosed with stage III or IV ovarian cancer with preoperative CT and/or PET/CT images from 2006 to 2022. Imaging studies were evaluated for the presence, size and location of suspicious EALNs. Suspicious lymph node enlargement was defined by a cut-off ≥5mm short-axis dimension on CT and/or lesions with maximum standardized uptake values of ≥2.5 on PET/CT. This study only included patients who did not have their EALNs surgically removed. A total 109 patients met the inclusion criteria; 36 (33%) had suspicious EALNs and were categorized as "node-positive". The median overall survival (OS) was 45.73 months for the "node-positive" and 46.50 months for the "node-negative" patients (HR 1.17, 95% CI 0.68-2.00, p = 0.579). In multivariate analysis, after adjusting for other variables selected by process of backward elimination using a significance level of p&lt;0.20, suspicious EALNs still showed no clinical significance on OS (aHR 1.20, 95% CI 0.67-2.13, p = 0.537) as well as progression-free survival (aHR 1.43, 95% CI 0.85-2.41, p = 0.174). Old age (aHR 2.23, 95% CI 1.28-3.89, p = 0.005) and platinum resistance (aHR 1.92, 95% CI 1.10-3.36, p = 0.023) affects adversely on OS. Suspicious EALNs did not worsen the prognosis of patients with advanced ovarian cancer. However, its impact on survival is not yet clarified. Further investigation is required to assess the clinical significance of suspicious EALNs on preoperative imaging studies.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38805507</pmid><doi>10.1371/journal.pone.0299205</doi><tpages>e0299205</tpages><orcidid>https://orcid.org/0000-0002-7219-6386</orcidid><orcidid>https://orcid.org/0009-0007-5775-0995</orcidid><orcidid>https://orcid.org/0000-0001-8601-1701</orcidid><orcidid>https://orcid.org/0000-0002-0562-5443</orcidid><orcidid>https://orcid.org/0000-0003-4640-963X</orcidid><oa>free_for_read</oa></addata></record>
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source Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry
subjects Abdomen
Adult
Aged
Aged, 80 and over
Biology and Life Sciences
Cancer
Cancer patients
Chemotherapy
Computed tomography
CT imaging
Data collection
Development and progression
Disease
Female
Humans
Lymph nodes
Lymph Nodes - diagnostic imaging
Lymph Nodes - pathology
Lymphatic Metastasis
Lymphatic system
Medical imaging
Medical prognosis
Medicine and Health Sciences
Middle Aged
Multivariate analysis
Neoplasm Staging
Oncology, Experimental
Ovarian cancer
Ovarian Neoplasms - diagnosis
Ovarian Neoplasms - diagnostic imaging
Ovarian Neoplasms - mortality
Ovarian Neoplasms - pathology
Ovarian Neoplasms - surgery
Patient outcomes
Patients
PET imaging
Physical Sciences
Platinum
Pleural effusion
Positron emission
Positron Emission Tomography Computed Tomography - methods
Prognosis
Research and Analysis Methods
Retrospective Studies
Surgery
Survival
Tomography
Tomography, X-Ray Computed
title Prognostic impact of suspicious extraabdominal lymph nodes on patient survival in advanced ovarian cancer
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