Gynecologic oncology · 2026
Assessment of survival and clinicopathologic characteristics associated with lymph node isolated tumor cells in epithelial ovarian cancer.
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Lee Matthew W, Friedman Emmeline L, Erfani Hadi, Keymeulen Sawa, Lee Alice J, Lim Angelina E, Roman Lynda D, Matsuo Koji
Аннотация
OBJECTIVE: To assess reported incidences, characteristics, and survival associated with isolated tumor cells (ITCs) in epithelial ovarian cancer.
METHODS: This retrospective cohort study queried the Commission-on-Cancer's National Cancer Database. The study population included 15,484 patients with epithelial ovarian cancer and American Joint Committee on Cancer classification T1-T3 / N0-N0(i+) / M0 who had lymph node evaluation at primary anti-cancer surgery from 2018 to 2023. Multivariable Cox proportional hazards regression model was created to assess overall survival (OS) associated with ITCs, adjusting for preoperative and intraoperative factors-derived propensity score and further postoperative chemotherapy.
RESULTS: A total of 157 (1.0%) patients had ITCs in regional lymph nodes, corresponding to one in 100 patients. Higher T classification was associated with higher incidence rate of ITCs (0.5%, 1.2%, and 2.6% for T1, T2, and T3 classification, respectively; adjusted-odd ratio [aOR] for T2 vs T1, 1.90, 95% confidence interval [CI] 1.21 to 3.00; and aOR for T3 vs T1 3.45, 95%Cl 2.29 to 5.20). Reported incidence rates of ITCs were higher for low-grade serous carcinoma compared to high-grade serous carcinoma (4.0% vs 1.5%, aOR 2.68, 95%Cl 1.66 to 4.31). In multivariable analysis, ITCs were statistically not associated with OS (4-year rates, 81.0% and 86.7%, adjusted-hazard ratio 0.94, 95%Cl 0.58 to 1.52). Results were similar in several subgroups (age < 60, age ≥ 60, T1, T2, and T3 classifications, high-grade serous, and low-grade serous) in exploratory analysis. This included adjusted-hazard ratio of 1.26 (95%CI 0.40 to 3.93) for T1 classification.
CONCLUSION: The results of this cohort study suggest that ITCs in the regional lymph node may not be a prognostic factor for short-term survival in epithelial ovarian cancer.
METHODS: This retrospective cohort study queried the Commission-on-Cancer's National Cancer Database. The study population included 15,484 patients with epithelial ovarian cancer and American Joint Committee on Cancer classification T1-T3 / N0-N0(i+) / M0 who had lymph node evaluation at primary anti-cancer surgery from 2018 to 2023. Multivariable Cox proportional hazards regression model was created to assess overall survival (OS) associated with ITCs, adjusting for preoperative and intraoperative factors-derived propensity score and further postoperative chemotherapy.
RESULTS: A total of 157 (1.0%) patients had ITCs in regional lymph nodes, corresponding to one in 100 patients. Higher T classification was associated with higher incidence rate of ITCs (0.5%, 1.2%, and 2.6% for T1, T2, and T3 classification, respectively; adjusted-odd ratio [aOR] for T2 vs T1, 1.90, 95% confidence interval [CI] 1.21 to 3.00; and aOR for T3 vs T1 3.45, 95%Cl 2.29 to 5.20). Reported incidence rates of ITCs were higher for low-grade serous carcinoma compared to high-grade serous carcinoma (4.0% vs 1.5%, aOR 2.68, 95%Cl 1.66 to 4.31). In multivariable analysis, ITCs were statistically not associated with OS (4-year rates, 81.0% and 86.7%, adjusted-hazard ratio 0.94, 95%Cl 0.58 to 1.52). Results were similar in several subgroups (age < 60, age ≥ 60, T1, T2, and T3 classifications, high-grade serous, and low-grade serous) in exploratory analysis. This included adjusted-hazard ratio of 1.26 (95%CI 0.40 to 3.93) for T1 classification.
CONCLUSION: The results of this cohort study suggest that ITCs in the regional lymph node may not be a prognostic factor for short-term survival in epithelial ovarian cancer.