腹膜后淋巴结切除术在早期卵巢上皮性癌的临床应用价值分析  

The Clinical Value of Retroperitoneal Lymphadenectomy for Early Stage Epithelial Ovarian Carcinoma

作　　者：汤岭梅 

机构地区：[1]重庆市江津区中医院妇产科,重庆402260

出　　处：《中国现代手术学杂志》2014年第4期301-304,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨腹膜后淋巴结切除术在早期卵巢上皮性癌患者中的临床疗效及预后价值。方法回顾性分析2012年1月-2013年5月收治的68例早期卵巢上皮性癌患者临床资料,根据手术方案不同分为两组：研究组36例,行肿瘤细胞减灭术及腹膜后淋巴结切除术治疗;对照组32例,因各种原因未接受腹膜后淋巴结切除,仅行肿瘤细胞减灭术。比较两组患者手术相关指标;术后均随访1年,比较两组复发率、复发平均时间以及生存率。应用COX风险比例回归模型分析影响预后的临床因素。结果两组患者手术时间、术中出血量及住院时间比较均无显著差异（P〉0.05）。与对照组相比,研究组复发率较低,复发平均时间延长,1年生存率较高,差异具有统计学意义（P〈0.05）。临床分期、病理类型及腹膜后淋巴结切除对预后结局有显著影响（P〈0.05）。结论腹膜后淋巴结切除术对早期卵巢上皮性癌患者的临床疗效肯定,预后结局较好,应尽量在临床开展。Objective To analyze the clinical effect and prognosis value of retroperitoneal lymphadenectomy on patients with early stage epithelial ovarian carcinoma. Methods The clinical data of 68 patients with early stage epithelial ovarian carcinoma were analyzed retrospective. According to surgical procedure, all cases were divided into two groups ： research group with 36 cases were received cytoreductive surgery plus retroperitoneal lymphadenectomy, and control group with 32 cases were not received retroperitoneal lymphadenectomy because of all kinds causes. The operative indexes such as operative duration, intra-operative blood loss and hospital stays were compared between two groups. All cases were followed up for one year. The indexes of recurrence rate, mean recurrence duration and survival rate were compared between two groups. The independent prognostic factors were identified by the COX proportional hazards regression model. Results There was no statistical difference in surgical factors of operative duration, intra-operative blood loss and hospital stays between two groups （P 〉 0.05）. Compared to control group, the index of the recurrence rate was lower （ P 〈 0.05 ）, mean recurrence duration was longer （ P 〈 0.05 ） , and one-year survival rate was higher in research group （ P 〈 0. 05 ）. The clinical stages, pathological types and retroperitoneal lymphadenectomy were confirmed to influence prognosis by the COX proportional hazards regression model. Conclusion The clinical and prognostic values of retroperitoneal lymphadenectomy is ideal and positive for early stage epithelial ovarian carcinoma, and it is worthy to be developing.

关 键 词：卵巢肿瘤 淋巴结切除术 腹膜后 预后 

分 类 号：R737.31[医药卫生—肿瘤]