Analysis of the Impact of Lymphadenectomy on Survival in FIGO Ⅱ-Ⅳ Ovarian Mucinous Carcinoma Based on the SEER Database

doi:10.12280/gjszjk.20260042

Abstract

Abstract:

Objective: To evaluate the relationship between the application of lymphadenectomy and overall survival in patients with FIGO stage Ⅱ-Ⅳ ovarian mucinous carcinoma, and to explore whether this relationship differs by lymph node metastasis status. Methods: Based on the Surveillance, Epidemiology, and End Results(SEER) database, we retrospectively identified the patients diagnosed with primary FIGO stage Ⅱ-Ⅳ ovarian mucinous carcinoma from 2004 to 2021. Clinical characteristics were compared between the patients who underwent lymphadenectomy and those who did not. Cox proportional hazard models were used to assess the association of lymphadenectomy and other clinical factors with overall survival, with stratified analysis conducted according to lymph node metastasis status. Results: A total of 726 patients were included, of whom 340 (46.8%) underwent lymphadenectomy. Among the 336 patients with pathological records of lymph nodes, 95 (28.3%) had lymph node metastasis. Compared with patients of the non-lymphadenectomy group, patients of the lymphadenectomy group were younger, had earlier FIGO stages and higher proportion of unilateral tumors, and were more likely to receive chemotherapy (all P<0.05). Multivariable Cox proportional hazard models analysis showed that lymphadenectomy was independently associated with longer overall survival (aHR=0.58, 95%CI: 0.48-0.70, P<0.001). Stratified analysis by lymph node metastasis status revealed that, compared with the patients of the non-lymphadenectomy group, the patients without lymph node metastasis who underwent lymphadenectomy had significantly longer overall survival (HR=0.41, 95%CI: 0.33-0.50, P<0.001), while no significant association was observed between lymphadenectomy and overall survival in those patients with lymph node metastasis (HR=0.87, 95%CI: 0.67-1.12, P=0.281). Conclusions: The clinical value of lymphadenectomy in FIGO stage Ⅱ-Ⅳ ovarian mucinous carcinoma may primarily lie in accurate staging and prognostic stratification. However, direct survival benefit remains to be further verified. Clinical decision-making should comprehensively balance the surgical tolerance and the risk of nodal metastasis.

Key words: Ovarian neoplasms, Adenocarcinoma, mucinous, Lymph node excision, Lymphatic metastasis, Proportional hazards models

FANG Jin, YANG Hui, WANG Zhi. Analysis of the Impact of Lymphadenectomy on Survival in FIGO Ⅱ-Ⅳ Ovarian Mucinous Carcinoma Based on the SEER Database[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(3): 184-189.

Figures/Tables 4

References 21

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特征	未行淋巴结清扫组（386例）	淋巴结清扫组（340例）	χ²	P
种族			-	0.373*
白种人	296（76.7）	271（79.7）
黑种人	48（12.4）	30（8.8）
其他	39（10.1）	38（11.2）
未知	3（0.8）	1（0.3）
年龄			8.203	0.004
≤ 55岁	160（41.5）	178（52.4）
>55岁	226（58.5）	162（47.6）
FIGO分期			17.915	<0.001
Ⅱ期	67（17.4）	99（29.1）
Ⅲ期	186（48.2）	160（47.1）
Ⅳ期	133（34.4）	81（23.8）
病理分级			2.923	0.404
Ⅰ级	60（15.5）	53（15.6）
Ⅱ级	85（22.0）	89（26.2）
Ⅲ级	75（19.5）	71（20.9）
未知	166（43.0）	127（37.4）
肿瘤侧别			10.677	0.001
单侧	240（62.2）	251（73.8）
双侧	146（37.8）	89（26.2）
化疗			4.286	0.038
否/未知	133（34.5）	92（27.1）
是	253（65.5）	248（72.9）

特征	未行淋巴结清扫组（386例）	淋巴结清扫组（340例）	χ²	P
种族			-	0.373*
白种人	296（76.7）	271（79.7）
黑种人	48（12.4）	30（8.8）
其他	39（10.1）	38（11.2）
未知	3（0.8）	1（0.3）
年龄			8.203	0.004
≤ 55岁	160（41.5）	178（52.4）
>55岁	226（58.5）	162（47.6）
FIGO分期			17.915	<0.001
Ⅱ期	67（17.4）	99（29.1）
Ⅲ期	186（48.2）	160（47.1）
Ⅳ期	133（34.4）	81（23.8）
病理分级			2.923	0.404
Ⅰ级	60（15.5）	53（15.6）
Ⅱ级	85（22.0）	89（26.2）
Ⅲ级	75（19.5）	71（20.9）
未知	166（43.0）	127（37.4）
肿瘤侧别			10.677	0.001
单侧	240（62.2）	251（73.8）
双侧	146（37.8）	89（26.2）
化疗			4.286	0.038
否/未知	133（34.5）	92（27.1）
是	253（65.5）	248（72.9）

特征分组	单因素分析			多因素分析
特征分组	HR	95%CI	P	aHR	95%CI	P
年龄
≤ 55岁	1			1
>55岁	1.34	1.12~1.60	0.001	1.37	1.14~1.64	<0.001
FIGO分期
Ⅱ期	1			1
Ⅲ期	3.17	2.38~4.23	<0.001	3.03	2.26~4.06	<0.001
Ⅳ期	5.33	3.95~7.21	<0.001	4.97	3.65~6.76	<0.001
病理分级
Ⅰ级	1			1
Ⅱ级	1.45	1.08~1.93	0.012	1.53	1.14~2.05	0.004
Ⅲ级	1.87	1.40~2.50	<0.001	1.90	1.42~2.55	<0.001
未知	1.19	0.90~1.57	0.228	1.11	0.84~1.47	0.450
肿瘤侧别
单侧	1			1
双侧	1.68	1.40~2.01	<0.001	1.24	1.03~1.49	0.024
淋巴结清扫术
否	1			1
是	0.50	0.42~0.61	<0.001	0.58	0.48~0.70	<0.001
化疗
否/未知	1			1
是	0.73	0.61~0.89	0.001	0.66	0.54~0.80	<0.001

特征分组	单因素分析			多因素分析
特征分组	HR	95%CI	P	aHR	95%CI	P
年龄
≤ 55岁	1			1
>55岁	1.34	1.12~1.60	0.001	1.37	1.14~1.64	<0.001
FIGO分期
Ⅱ期	1			1
Ⅲ期	3.17	2.38~4.23	<0.001	3.03	2.26~4.06	<0.001
Ⅳ期	5.33	3.95~7.21	<0.001	4.97	3.65~6.76	<0.001
病理分级
Ⅰ级	1			1
Ⅱ级	1.45	1.08~1.93	0.012	1.53	1.14~2.05	0.004
Ⅲ级	1.87	1.40~2.50	<0.001	1.90	1.42~2.55	<0.001
未知	1.19	0.90~1.57	0.228	1.11	0.84~1.47	0.450
肿瘤侧别
单侧	1			1
双侧	1.68	1.40~2.01	<0.001	1.24	1.03~1.49	0.024
淋巴结清扫术
否	1			1
是	0.50	0.42~0.61	<0.001	0.58	0.48~0.70	<0.001
化疗
否/未知	1			1
是	0.73	0.61~0.89	0.001	0.66	0.54~0.80	<0.001

特征	无淋巴结转移组（241例）	伴淋巴结转移组（95例）	χ²	P
年龄			1.653	0.199
≤55岁	119（49.4）	55（57.9）
>55岁	122（50.6）	40（42.1）
FIGO分期			54.222	<0.001
Ⅱ期	96（39.8）	0（0.0）
Ⅲ期	93（38.6）	67（70.5）
Ⅳ期	52（21.6）	28（29.5）
病理分级			6.045	0.109
Ⅰ级	39（16.2）	14（14.7）
Ⅱ级	66（27.4）	22（23.1）
Ⅲ级	42（17.4）	28（29.6）
未知	94（39.0）	31（32.6）
肿瘤侧别			2.397	0.122
单侧	184（76.3）	64（67.4）
双侧	57（23.7）	31（32.6）
化疗			0.209	0.648
否/未知	66（27.4）	23（24.2）
是	175（72.6）	72（75.8）
切除淋巴结数量			1.550	0.213
≤ 3个	74（30.7）	22（23.2）
>3个	167（69.3）	73（76.8）