Deep epigastric lymph nodes implication in patients' recurrence pattern after cytoreductive surgery in ovarian peritoneal metastases.
Female
Humans
Peritoneum
/ pathology
Peritoneal Neoplasms
/ diagnostic imaging
Cytoreduction Surgical Procedures
Retrospective Studies
Neoplasm Recurrence, Local
/ pathology
Ovarian Neoplasms
/ diagnostic imaging
Lymph Nodes
/ diagnostic imaging
Hyperthermia, Induced
Combined Modality Therapy
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Cytoreductive surgery
Lymph nodes
Ovarian cancer
Peritoneal carcinomatosis
Recurrence
Journal
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
07
10
2022
revised:
16
03
2023
accepted:
19
04
2023
medline:
13
9
2023
pubmed:
7
5
2023
entrez:
6
5
2023
Statut:
ppublish
Résumé
Although complete cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) offers a good prognosis in patients with peritoneal metastasis of ovarian cancer (PMOC), recurrences are quite common. These recurrences can be intra-abdominal or systemic in nature. Our objective was to study and illustrate the global recurrence pattern in patients operated for PMOC, shedding light on a previously overlooked lymphatic basin at the level of the epigastric artery, the deep epigastric lymph nodes (DELN) basin. This was a retrospective study including patients with PMOC who underwent surgery with curative-intent, from 2012 until 2018, at our cancer center, and who presented with any type of disease recurrence on follow-up. CT-scans, MRIs and PET-scans were reviewed in order to determine solid organs and lymph nodes (LN) recurrences. During the study period, 208 patients underwent CRS ± HIPEC, 115 (55.3%) presented with organ or lymphatic recurrence over a median follow-up of 81 months. Sixty percent of these patients had radiologically enlarged LN involvement. The pelvis/pelvic peritoneum was the most common intra-abdominal organ recurrence site (47%), while the retroperitoneal LN was the most common lymphatic recurrence site (73.9%). Previously overlooked DELN were found in 12 patients, with 17.4% implication in lymphatic basin recurrence patterns. Our study revealed the potential role of the DELN basin, previously overlooked in the systemic dissemination process of PMOC. This study sheds light on a previously unrecognized lymphatic pathway, as an intermediate checkpoint or relay, between the peritoneum, an intra-abdominal organ, and the extra-abdominal compartment.
Identifiants
pubmed: 37149402
pii: S0748-7983(23)00465-1
doi: 10.1016/j.ejso.2023.04.010
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
106911Informations de copyright
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest Authors declare no conflict of interest.