ArticleJournal of gynecologic oncology2026
Clinical analysis of the impact of systematic pelvic and para-aortic lymphadenectomy on the prognosis of patients with early-stage ovarian cancer (stage IA-IIA): a propensity score matching study.
Article in Journal of gynecologic oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe role of systematic pelvic and para-aortic lymphadenectomy (PPAL) in completion staging surgery for early-stage (stage I-IIA) ovarian cancer (EOC) remains controversial. This study evaluates the impact of PPAL on the prognosis of EOC patients.
methodsA retrospective cohort study was conducted using data from the Surveillance, Epidemiology, and End Results database. Patients with EOC (stage I-IIA) were included. Propensity score matching (PSM) was used at a 1:1 ratio based on age, marital status, race, tumor grade, histological type, FIGO stage, and postoperative adjuvant therapy. Post-matching overall survival (OS) and cancer-specific survival (CSS) were compared between the systematic PPAL group (pathological staging) and the non-lymphadenectomy group (clinical staging).
resultsAfter PSM, no significant differences were observed in OS (p=0.140) and CSS (p=0.066) between the two groups. Subgroup analysis showed that for tumor grade III patients, the pathological staging group had significantly higher OS (p=0.028) and CSS (p=0.010) than the clinical staging group. Multivariate Cox regression indicated that tumor grade III was an independent prognostic factor for OS (p=0.006) and CSS (p=0.020).
conclusionSystematic PPAL does not significantly improve survival in EOC patients. However, for tumor grade III patients, the pathological staging group demonstrates significantly better prognosis, offering a more personalized alternative to routine staging surgery, which requires further validation through prospective trials.
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