卵巢癌二探术中广泛切除腹膜后淋巴结的疗效  

Therapeutic results of second look laporatomy with extensive dissection of retroperitoneal lymph nodes in ovarian cancer patients

作　　者：吴小华[1] 张志毅[1] 唐美琴[1] 陈洁[1] 

机构地区：[1]上海医科大学肿瘤医院妇科

出　　处：《中华肿瘤杂志》1999年第4期300-302,共3页Chinese Journal of Oncology

摘　　要：目的　回顾性分析卵巢癌二探术中施行腹膜后淋巴结广泛切除的疗效。方法　在二探术过程中均行系统的腹膜后淋巴结切除术，包括左肾静脉下缘水平的腹主动脉旁淋巴结和盆腔各组淋巴结，回顾性分析行二探术阳性发现结果和患者的预后。结果　接受二探术治疗的６３ 例患者中，２４ 例（３８．１％ ） 发现有肿瘤残存，二探术阳性率与临床期别、首次细胞减灭术后残留灶大小正相关，而与组织分化程度无关。在淋巴结转移（ｌｙｍｐｈ ｎｏｄｅ ｍｅｔａｓｔａｓｉｓ，ＬＮＭ） 的１９ 例（３０．２％ ） 中，仅有８ 例无盆腹腔残留肿瘤。３９ 例二探术阴性患者中，４ 例（１０ ．３ ％ ） 复发。全部患者的３ 年和５ 年生存率分别为７５．４ ％ 和６８ ．３％ 。结论　在二探术中行淋巴结切除术扩大了探查范围，可减低卵巢癌患者阴性二探术后的复发率。Objective To evaluate retrospectively the results of extensive lymphadenectomy during second look laparotomy in patients with ovarian cancer.Methods A total of 63 patients with ovarian malignancies received second look laparotomy (SLL). Retroperitoneal lymph nodes, including para aortic nodes below the level of left renal vein and pelvic nodes were extensively dissected.Results Of the 63 patients, residual tumor was found in 24 (38.1%) on SLL. The frequency of residual tumor was positively correlated with the clinical stage and with the amount of tumor left after initial debulking but not with degree of differentiation of tumor cells. Lymph node metastasis was pathologically confirmed in 19 cases (30.2%), in which no residual tumor was found in 8 patients. Tumor recurred in only 4 of the 39 patients (10.3%) with negative SLL. The overall 3 and 5 year survival rate was 75.4% and 68.3%, respectively.Conclusion Extensive retroperitoneal lymph node dissection is recommended during SLL. It favors a decrease in recurrence rate in ovarian cancer patients negative on SLL.

关 键 词：卵巢肿瘤 淋巴结切除术 二次探查术 

分 类 号：R737.310.5[医药卫生—肿瘤]