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Patients with IIIA1 disease experience more favorable outcomes than those with peritoneal dissemination; however, the prognostic determinants within this subgroup remain incompletely defined and underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative review was conducted by using concept\u2011based searches. Eligible reports included those specifically addressing stage IIIA1 or providing extractable node\u2011positive subsets within stage III cohorts. Given heterogeneity in surgical eras, lymphadenectomy practices, and histologic composition, no quantitative pooling was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nodal size and the IIIA1(i)\/(ii) subdivision did not consistently correlate with survival. In contrast, nodal topography showed signals of prognostic relevance in selected cohorts. The lymph node ratio (LNR) emerged as the most robust determinant of outcome. Systematic pelvic and para\u2011aortic lymphadenectomy, typically involving retrieval of \u226510\u201320 nodes, was linked to improved staging accuracy and long\u2011term survival. Tumor microenvironment features provided additional prognostic stratification, while IIIA1\u2011specific molecular data remained limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In FIGO IIIA1 ovarian cancer, nodal topography and burden represent the most reliable prognostic indicators. Systematic lymphadenectomy appears beneficial in appropriately selected patients, and tumor microenvironment features offer complementary risk stratification. Future studies should focus on genomically characterized IIIA1 cohorts to refine risk\u2011adapted surgical and maintenance strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-026-19895-5","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T16:25:04Z","timestamp":1780417504000},"page":"8380-8389","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictive Features Specific to FIGO IIIA1 Ovarian Cancer: What Drives Prognosis"],"prefix":"10.1245","volume":"33","author":[{"given":"Matteo","family":"Bruno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Arrigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Paratore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giustina","family":"Lopopolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Gallotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rosati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6588-8686","authenticated-orcid":false,"given":"Marco","family":"D\u2019Indinosante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Fagotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"issue":"4","key":"19895_CR1","doi-asserted-by":"publisher","first-page":"352","DOI":"10.3802\/jgo.2013.24.4.352","volume":"24","author":"DH Suh","year":"2013","unstructured":"Suh DH, Kim TH, Kim JW, et al. 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