晚期上皮性卵巢癌腹膜后淋巴结清扫的临床价值  

Clinical value of retroperitoneal lymph nodes dissection on advanced epithelial ovarian cancer

作　　者：许冬娣[1] 汪艳[1] 

机构地区：[1]安徽省安庆市立医院妇产科,安徽安庆246003

出　　处：《实用临床医药杂志》2013年第9期156-158,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11320097)

摘　　要：目的评价腹膜后淋巴结清扫对晚期上皮性卵巢癌预后的影响。方法将67例晚期上皮性卵巢癌患者随机分为研究组32例及对照组35例。研究组行卵巢肿瘤细胞减灭术+术后规范化疗,对照组行卵巢肿瘤细胞减灭术+腹膜后淋巴结清扫术+术后规范化疗,对比2组手术时间、术中出血量、术后病率及术后1、3、5年生存率的差异。结果研究组术中出血量、手术时间、术后病率均显著小于对照组。2组1、3、5年生存率均无显著差异;而2组术后残留癌灶<1.0 cm的患者3、5年生存率均显著高于同组残留癌灶≥1.0 cm的患者。结论理想的肿瘤减灭术是影响晚期上皮性卵巢癌患者预后的重要因素,而腹膜后淋巴结清扫不能提高晚期上皮性卵巢癌的生存率,反而使围手术期的并发症显著提高。Objective To evaluate the influence of retroperitoneal lymph nodes dissection（RPLND） on the prognosis of advanced epithelial ovarian cancer（EOC）.Methods Sixty-seven patients with advanced EOC were randomly divided into research group（n=32） and control group（n=35）.Patients in research group were treated with ovary cytoreductive surgery and standard postoperative chemotherapy,while those in the control group with ovary cytoreductive surgery,RPLND and standard postoperative chemotherapy.The operation time,intraoperative bleeding,postoperative morbidity as well as 1,3,and 5-year survival rates of the two groups were compared.Results The intraoperative bleeding,operation time and postoperative morbidity in research group were all less than those in the control group.There were no significant differences in 1,3,and 5-year survival rates of 2 groups whether residual cancer focus is less than 1.0 cm or more than it,whereas both 3 and 5-year survival rates of patients with postoperative residual cancer focus1.0 cm in the two groups were notably higher than those with residual cancer focus≥1.0 cm in the same group.Conclusion The ideal tumor reductive surgery is an important factor to influence the prognosis of patients with advanced EOC,whereas RPLND markedly increases the complications of advanced EOC in perioperative period instead of improving its survival rate.

关 键 词：晚期上皮性卵巢癌 腹膜后淋巴结清扫 术后残留癌灶 生存率 

分 类 号：R737.31[医药卫生—肿瘤]