Gynecologic oncology · 2026
Impact of lymphadenectomy on survival outcomes for stage I malignant ovarian germ cell tumors.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ludmir Delanie, Huang Yongmei, Xu Xiao, Dioun Shayan, Buckley Alexander, Randall Thomas, Pua Tarah, St Clair Caryn M, Hou June Y, Matsuo Koji, Hershman Dawn L, Wright Jason D
Аннотация
OBJECTIVE: Malignant ovarian germ cell tumors (MOGCTs) are rare non-epithelial ovarian malignancies. Although comprehensive surgical staging, including lymphadenectomy, is recommended by current guidelines, the prognostic benefit in early-stage disease remains uncertain. We evaluated patterns of lymphadenectomy use and its association with survival in stage T1 MOGCTs.
METHODS: Using the National Cancer Database, we identified women with stage T1 MOGCTs diagnosed between 2018 and 2022. Multivariable log-linear regression was used to identify factors associated with lymphadenectomy. Propensity score inverse probability of treatment weighting (IPTW) was applied to estimate the association between lymphadenectomy and survival using weighted Kaplan-Meier and Cox proportional-hazards models.
RESULTS: Among 740 patients, 47.3% underwent lymphadenectomy, with use declining from 53.3% in 2018 to 36.2% in 2022 (P = 0.02). Dysgerminoma histology (aRR 1.78, 95% CI: 1.19-2.66), larger tumor size (>150 mm, aRR 1.44, 95% CI: 1.03-2.01), and performance of hysterectomy (aRR 1.40, 95% CI: 1.04-1.87) were associated with increased likelihood of undergoing lymphadenectomy. The median number of nodes examined was 9 (IQR 4-16), with nodal metastases identified in 6.6% of cases, most commonly among dysgerminomas. After PS IPTW, patients who underwent lymphadenectomy were more likely to receive adjuvant chemotherapy (52.8% vs. 44.7%; SMD = 0.16), and lymphadenectomy was not associated with improved survival (aHR 1.23, 95% CI: 0.38-4.06).
CONCLUSIONS: In stage T1 MOGCTs, lymphadenectomy was not associated with improved survival but was associated with higher rates of adjuvant chemotherapy use. Given the low rate of nodal metastasis and excellent survival outcomes, a selective approach to lymphadenectomy may be appropriate.
METHODS: Using the National Cancer Database, we identified women with stage T1 MOGCTs diagnosed between 2018 and 2022. Multivariable log-linear regression was used to identify factors associated with lymphadenectomy. Propensity score inverse probability of treatment weighting (IPTW) was applied to estimate the association between lymphadenectomy and survival using weighted Kaplan-Meier and Cox proportional-hazards models.
RESULTS: Among 740 patients, 47.3% underwent lymphadenectomy, with use declining from 53.3% in 2018 to 36.2% in 2022 (P = 0.02). Dysgerminoma histology (aRR 1.78, 95% CI: 1.19-2.66), larger tumor size (>150 mm, aRR 1.44, 95% CI: 1.03-2.01), and performance of hysterectomy (aRR 1.40, 95% CI: 1.04-1.87) were associated with increased likelihood of undergoing lymphadenectomy. The median number of nodes examined was 9 (IQR 4-16), with nodal metastases identified in 6.6% of cases, most commonly among dysgerminomas. After PS IPTW, patients who underwent lymphadenectomy were more likely to receive adjuvant chemotherapy (52.8% vs. 44.7%; SMD = 0.16), and lymphadenectomy was not associated with improved survival (aHR 1.23, 95% CI: 0.38-4.06).
CONCLUSIONS: In stage T1 MOGCTs, lymphadenectomy was not associated with improved survival but was associated with higher rates of adjuvant chemotherapy use. Given the low rate of nodal metastasis and excellent survival outcomes, a selective approach to lymphadenectomy may be appropriate.