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LION

A Randomized Trial of Lymphadenectomy in Patients With Advanced Ovarian Neoplasms

Date of Publication:

February 28, 2019

Pubmed Link:
https://pubmed.ncbi.nlm.nih.gov/30811909/
Hypothesis:

Does performing a lymphadenectomy during primary surgical debulking improve survival in women with advanced ovarian cancer and clinically negative LN?

Control Arm(s):

No lymphadenectomy at time of primary surgical debulking

Experimental Arm(s):

Systematic lymphadenectomy at time of primary surgical debulking

Primary End Point:

OS

Inclusion Criteria:

Resectable stage IIB-IV ovarian cancer

Macroscopic resection  

Clinically negative lymph nodes

Exclusion Criteria:
Results:

Lymphadenectomy vs. No Lymphadenectomy:

median PFS: 25.5 vs. 25.5 months (NS)

median OS: 65.5 vs. 69.2 mos (NS)

Lymph cysts (symptomatic): 3.1% vs. 0% (SS)

Repeat laparotomy: 12.4% vs. 6.5% (SS)

Transfusion PRBC: 63.7% vs. 56% (SS)

60-day mortality: 3.1% vs. 0.9% (SS)

Conclusions:

Systematic lymphadenectomy was not associated with improved OS in women with advanced ovarian cancer, and was associated with a higher incidence of postoperative complications, including death.

Reviewer:
Stuart S. Winkler MD FACOG, OTF