Table 1.
Previous reports of isolated lymph node relapse ovarian carcinoma
| ILNR cases | N | Ferrero16 |
Tu15 |
Gadducci14 |
Fotiou18 |
Legge12 |
Santillan17 |
Blanchard11 |
Uzan13 |
Summary |
|---|---|---|---|---|---|---|---|---|---|---|
| 73 | 38 | 69 | 21 | 32 | 25 | 27 | 12 | Few reports of ≥40 cases | ||
| Age at diagnosis | Years | Median 54 | 24 (63%) >50; 14 (37%) ≤50 | Median 58 | Mean 50 | Median 60 | Mean 58 | Mean 59 | Median 51 | Largely unremarkable compared with unselected OC cohorts |
| Range | 29–73 | 34–78 | 36–67 | 45–76 | 41–82 | 41-85 | 42–71 | |||
| Stage at diagnosis | I | 14 (19%) | 0 | 11 (16%) | 3 (14%) | 0 | 2 (8%) | 4 (15%) | 5 (42%) | |
| II | 4 (6%) | 15 (39%) | 6 (9%) | 3 (14%) | 1 (3%) | 5 (20%) | 5 (18%) | 1 (8%) | ||
| III | 51 (70%) | 23 (61%) | 46 (67%) | 14 (67%) | 29 (91%) | 15 (60%) | 15 (56%) | 6 (50%) | ||
| IV | 4 (6%) | 0 | 6 (9%) | 1 (5%) | 2 (6%) | 3 (12%) | 3 (11%) | 0 | ||
| RD following first-line debulking | 0 cm / <0.5 cm | 57 (78%) | 17 (45%) | 22 (32%) | 8 (38%) | 14 (44%) | 18 (72%) | NA | 7 (58%) | |
| ≤1 cm | 10 (14%) | 10 (26%) | 11 (16%) | 7 (33%) | 6 (19%) | 5 (20%) | NA | 4 (33%) | ||
| <2 cm | 4 (6%) | 11 (29%) | 36 (52%) | 4 (19%) | 0 | NA | ||||
| >2 cm | 2 (3%) | 2 (10%) | 12 (38%) | 2 (8%) | NA | 1 (8%) | ||||
| Grade at diagnosis | I | 4 (6%) | 7 (18%) | 3 (4%) | 0 | 9 (32%) | 25 (100%) high grade | NA | NA | |
| II | 5 (7%) | 14 (37%) | 13 (19%) | 8 (38%) | ||||||
| III | 64 (88%) | 17 (45%) | 54 (78%) | 13 (62%) | 19 (68%) | |||||
| NA | - | - | - | - | 4 | - | ||||
| Reported histologic subtype at diagnosis | Serous | 53 (73%) | 19 (50%) | 52 (75%) | 16 (76%) | 26 (81%) | 19 (76%) | 17 (62%)a | 8 (67%) | Predominantly serous / HGS cases, as with unselected OC cohorts |
| Endometrioid | 11 (15%) | 9 (24%) | 12 (17%) | 5 (24%) | 2 (6%) | 2 (8%) | 3 (11%) | 3 (25%) | ||
| Clear cell | 0 | 0 | 1 (1%) | 0 | 0 | 0 | 0 | |||
| Mucinous | 1 (1%) | 1 (3%) | 0 | 1 (3%) | 0 | 3 (11%) | 0 | |||
| Other | 8 (11%) | 9 (24%) | 4 (6%) | 3 (9%) | 4 (16%) | 4 (15%) | 1 (8%) | |||
| DFI / time to ILNRb | Median months | 18 | 18 | 44 (62%) >12 months |
21 | 17.5 | 16 | 26 months from diagnosis | 21 | Median 1.5–2 years DFI |
| Range | 6–192 | 9-96 | 8–156 | 1–134 | 6–40 | 1–159 | 6–72 | |||
| ILNR site(s) | Para-aortic only | 37 (51%) | 10 (26%) | 23 (33%) | 8 (38%) | 14 (44%) | 15 (60%) | 9 (33%) retro. alone, 6(22%) retro. + other. supraclavicular, mediastinal, iliac, and inguinal involvement in 7 (26%), 4 (15%), 4 (15%), and 3 (11%) cases | 5 (42%) | Most commonly involves pelvic and/or para-aortic sites |
| Pelvic only | 21 (29%) | 15 (39%) | 12 (17%) | 4 (19%) | 1 (3%) | 3 (12%) | 4 (33%) | |||
| Para-aortic & pelvic | 9 (12%) | 7 (18%) | 6 (9%) | 4 (19%) | 9 (28%) | 1 (4%) | 1 (8%) | |||
| Inguinal only | 3 (4%) | 2 (5%) | 12 (17%) | 4 (19%) | 2 (6%) | 5 (20%) | 1 (8%) | |||
| Other combinations | 3 (4%) | 4 (11%) | 16 (23%) | 1 (5%) | 6 (19%) | 1 (4%) | 1 (8%) | |||
| ILNR pattern | Single region | 61 (84%) | 27 (71%) | 47 (77%) | 17 (81%) | 20 (63%) | 24 (96%) | 17 (63%) | 10 (83%) | Most commonly localized to a single region |
| Multiregion | 12 (16%) | 11 (29%) | 14 (23%) | 4 (19%) | 9 (28%) | 1 (4%) | 10 (37%) | 2 (17%) | ||
| NA | - | - | 8 | - | 3 | - | - | - | ||
| PRS | Median months | 5-y PRS 64%; 5-y OS ∼80% | 5-y PRS 66.5% | 32.1 | 47 | 37 | 37 | 26 | 5-y PRS 71% | Median 2–4 years |
| OS | Median months | 62.9 | 66 | 109 | 61 | 68 | Median >5 years | |||
| Surgery for ILNR | Yes | 73 (100%) | 19 (50%) | 24 (35%) | 21 (100%) | 12 (38%) | 25 (100%) | 8 (30%) | 12 (100%) | Heterogeneous management, typically involving chemotherapy |
| No | 0 | 19 (50%) | 45 (65%) | 0 | 20 (63%) | 0 | 19 (70%) | 0 | ||
| ILNR intervention: regime | Chemo alone | 0 | 5 (13%) | 44 (64%) | 0 | 19 (59%) | 0 | 8 (30%) | 0 | |
| Surgery alone | 3 (4%) | 0 | 1 (1%) | 0 | 1 (3%) | 2 (8%) | 2 (7%) | 0 | ||
| Surgery-chemo combination | 70 (96%) | 19 (50%) | 22 (32%) | 17 (81%) | 11 (34%) | 15 (60%) | 5 (19%) | 10 (83%) | ||
| Radio alone | 0 | 0 | 1 (1%) | 0 | 0 | 0 | 2 (7%) | 0 | ||
| No intervention | 0 | 0 | 0 | 0 | 1 (3%) | 0 | 7 (26%) | 0 | ||
| Other | 0 | 14 (37%) | 1 (1%) | 4 (19%) | 0 | 8 (32%) | 3 (11%) | 2 (17%) |
Chemo, chemotherapy; DFI, disease-free interval; ENR, extranodal relapse; ILNR, isolated lymph node relapse; NA, not available; OS, overall survival; PRS, postrelapse survival; radio, radiotherapy; RD, residual disease; retro, retroperitoneal.
Hollis et al. Clinical and molecular characterization of ILNR ovarian carcinoma. Am J Obstet Gynecol 2019.
a
Includes 5 cases described as papillary
b
From end of first-line chemotherapy.