Lymph node involvement, surgery and adjuvant treatment in primary Endometrioid Ovarian carcinoma PAtients with eaRly-stage Disease (LEOPARD) - a multinational team initiative.
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Grube Marcel, Ribeiro de Souza Bianca, Neilson Andrea, Tinker Anna, Staebler Annette, Kuzma Tamara, Nelson Gregg S, de Kroon Cor, Bosse Tjalling, Kroep Judith R, Teo-Fortin Ly-Ann, Bachvarov Dimcho, Brummel Koen, de Bruyn Marco, Nijman Hans, Andres Sophia, Schochter Fabienne, Fink Angelina, Moubarak Malak, Heitz Florian, Harter Philipp, Bartl Thomas, Grimm Christoph, Hofstetter Gerda, Sideris Michail, Manchanda Ranjit, Heublein Sabine, Fischer-Straub Anna, Kommoss Felix K F, Kulkarni Anjali, Vanderhyden Barbara, Knoll Katharina, Zeimet Alain, Wimberger Pauline, Link Theresa, Jaeger Anna, Schmalfeldt Barbara, Lampe Björn, Yasmeen Amber, Phouthavongsy Larry, Vollert Hans Walter, Lycke Maria, Mateoiu Constantia Claudia, Irving Julie, Watson Peter, Nachtigal Mark, de Ladurantaye Manon, van de Laar Emily, Plante Marie, Kommoss Friedrich, Talhouk Aline, Koebel Martin, Anglesio Michael S, Kommoss Stefan
Аннотация
METHODS: ENOC cases from 22 centers across five countries underwent IHC-supported central pathology review. Standardized chart review captured patient characteristics, detailed surgical and adjuvant treatment data.
RESULTS: A total of 721 centrally confirmed ENOC cases diagnosed between 1984 and 2020 was assembled. Median age was 55.6 years; 86.0% presented with pelvic-confined disease, and 45.1% had grade 1 tumors. Complete resection was achieved in 96.5% of pT1/2 and 62.6% of pT3 cases. LN surgery (LNS) was performed in 58.3% of presumed early-stage cases, revealing nodal metastases in 2.6%, occurring in 4/255 (1.6%) after sampling and 5/95 (5.3%) after systematic LNS. No nodal metastases were observed in grade 1 pelvic-confined tumors (0/171). Adjuvant chemotherapy was administered in 68.0% of FIGOI/II cases and 95.5% of advanced-stage disease. Multivariable analyses revealed grade (p = 0.0006), stage (p = 0.0030) and chemotherapy (p = 0.0219) as independent prognosticators.
CONCLUSIONS: This multinational initiative enabled detailed analyses in a large cohort of validated ENOC. According to our results, LNS may be safely omitted in patients with pelvic-confined G1 tumors, however, if LNS is deemed necessary, a systematic approach seems to result in higher detection rates. The findings presented herein may help to shape type-specific treatment, ultimately aiming to reduce not only ovarian carcinoma mortality but also treatment-associated morbidity.