腹膜后淋巴结切除在卵巢内胚窦瘤治疗中的价值  

Significance of retroperitioned lymph node excision in the treatment of ovarian endodermal sinus tumor

作　　者：吴裕中[1] 曲军卫[1] 倪静[1] 王金华[1] 

机构地区：[1]南京医科大学附属肿瘤医院妇科肿瘤科,江苏南京210009

出　　处：《中国肿瘤外科杂志》2015年第5期287-291,共5页Chinese Journal of Surgical Oncology

摘　　要：目的探讨腹膜后淋巴结切除术对卵巢内胚窦瘤患者肿瘤复发和预后的影响。方法回顾性分析1996年2月至2010年3月收治的52例卵巢内胚窦瘤患者的临床资料,根据手术方案不同分为两组:淋巴结切除组22例,行肿瘤切除术及腹膜后淋巴结切除术;淋巴结未切除组30例,未接受腹膜后淋巴结切除,仅行肿瘤切除术。比较两组患者复发率,并分析影响患者复发率的临床因素。结果腹膜后淋巴结切除组在复发率、复发平均间隔时间方面与淋巴结未切除组相比均无明显差异(P>0.05)。临床分期、是否采用BEP方案化疗及术后甲胎蛋白恢复正常所需化疗疗程数是影响肿瘤复发的显著性因素(P<0.05),其中化疗方案及术后甲胎蛋白恢复正常所需化疗疗程数影响最大(P<0.01),是否有腹膜后淋巴结转移对患者的预后并无明显影响。结论内胚窦瘤患者不能从腹膜后淋巴结切除术中获益,术后规范化的化疗更有助于改善患者的预后。Objective To evaluate the impact of lymphadenectomy on the relapse and survival of ovarian endodermal sinus tumor. Methods The clinical data of 52 OYST cases treated in Jiangsu Cancer Hospital from Feb. 1996 to Mar. 2010 were analyzed retrospectively. According to surgical procedure,all cases were divided into two groups：research group with 22 cases received cytoreductive surgery plus retroperitoneal lymphadenecto-my,and control group with 30 cases did not receive retroperitoneal lymphadenectomy. The indexes of recurrence rate were compared between two groups and the independent factors related to relapse of disease were identified. Results There was no statistical difference in the recurrence rate and mean recurrence duration between two groups （P〈0. 05）. International Federation of Gynecology and Obstetrics （FIGO） staging,chemotherapy regi-men,and required chemotherapy courses that got the serum AFP levels back to normal were the significant fac-tors related to the relapse. Moreover,the presence of lymph node metastasis had no significant effect on relapse. Conclusion Lymphadenectomy may not bring benefitial effect for patients and standardized chemotherapy can improve the prognosis of patients with OYST.

关 键 词：卵巢内胚窦瘤 淋巴结切除术 化疗 复发 

分 类 号：R737.31[医药卫生—肿瘤]