Clinical Medicine Impact of Lymphadenectomy on Survival of Patients with Serous Advanced Ovarian Cancer After Neoadjuvant Chemotherapy: A French National Multicenter Study (FRANCOGYN)

Virginie Bund (1) , Lise Lecointre (2, 1, 3) , Michel Velten (1) , Lobna Ouldamer (4) , Sofiane Bendifallah (5) , Martin Koskas (6) , Pierre-Adrien Bolze (7) , Pierre Collinet (8) , Geoffroy Canlorbe (9, 9) , Cyril Touboul (10) , Cyrille Huchon (11) , Charles Coutant (12) , Emilie Faller (1) , Thomas Boisramé (1) , Justine Gantzer (1) , Martin Demarchi (13) , Jean-Jacques Baldauf (1) , Marcos Ballester (14) , Vincent Lavoué (15) , Chérif Akladios (1)

1 HUS - Les Hôpitaux Universitaires de Strasbourg
2 ICube - Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie
3 IHU Strasbourg - L'Institut hospitalo-universitaire de Strasbourg
4 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
5 CHU Tenon [AP-HP]
6 CIC Hôpital Bichat
7 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
8 Hôpital Jeanne de Flandres
9 CHU Pitié-Salpêtrière [AP-HP]
10 CHIC - Centre Hospitalier Intercommunal de Créteil
11 CHI Poissy-Saint-Germain
12 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
13 CRLCC Paul Strauss - Centre Paul Strauss
14 Groupe Hospitalier Diaconesses Croix Saint-Simon
15 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]

Background: The population of interest to this study comprised individuals with advanced-stage ovarian carcinoma who were exposed to neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). Those who had not received systematic lymphadenectomy (SL; Group 1) were compared to those who had received SL (Group 2). Outcome measures included progression-free survival (PFS), overall survival (OS), and surgical complications. Methods: This was a retrospective, multicenter cohort study in nine referral centers of France between January 2000 and June 2017. OS analysis using the multivariate Cox regression model was performed. PFS and surgery-related morbidity were analyzed. Results: Of the 255 patients included, 100 were in Group 1 and 155 in Group 2. Patient majority was, on average, younger and less comorbid, with predominant R0 surgery in Group 2. Dindo-Clavien score was similar between the two groups (p = 0.15). Median OS was 26.8 months in Group 2 and 27.6 months in Group 1. SL was not statistically significant on OS (p = 0.7). Median PFS was 18.3 months in Group 2 and 16.6 months in Group 1. SL had positive impact on PFS (p = 0.005). Conclusions: patients who had received SL (Group 2) had significantly higher PFS regardless of node-positivity status when compared to those who had not received SL (Group 1).

Domaines: Cancer; Gynécologie et obstétrique; Chirurgie; Santé publique et épidémiologie

Virginie Bund, Lise Lecointre, Michel Velten, Lobna Ouldamer, Sofiane Bendifallah, et al.. Clinical Medicine Impact of Lymphadenectomy on Survival of Patients with Serous Advanced Ovarian Cancer After Neoadjuvant Chemotherapy: A French National Multicenter Study (FRANCOGYN). Journal of Clinical Medicine, 2020, 2020 (8), pp.2427. ⟨10.3390/jcm9082427⟩. ⟨hal-02944542⟩