初次肿瘤细胞减灭术中行系统性腹膜后淋巴结清扫对晚期卵巢癌预后的影响  

Impact of systematic retroperitoneal lymphadenectomy during primary debulking surgery on prognosis in patients with advanced ovarian cancer

作　　者：顾海风[1] 黄绮丹[1] 涂画[1] 

机构地区：[1]中山大学肿瘤防治中心妇科,华南肿瘤学国家重点实验室,广州市510060

出　　处：《实用医学杂志》2016年第10期1623-1627,共5页The Journal of Practical Medicine

摘　　要：目的:探讨初次肿瘤细胞减灭术中行系统性腹膜后淋巴结清扫(SL)对于晚期卵巢癌预后的影响。方法:回顾性分析我院上皮性卵巢癌ⅢC期患者188例。所有患者均直接行肿瘤细胞减灭术+铂类为基础的术后辅助化疗。患者分为SL组和非SL组(USL组),分析其预后。结果:SL组中位无进展生存期和中位总生存期均高于USL组(36个月vs.17个月,P=0.022;58个月vs.52个月,P=0.041)。单因素分析提示SL、满意减灭是独立预后因素,但多因素分析仅提示满意减灭是独立预后因素。对于143例术中探查无腹膜后淋巴结肿大的患者,多因素分析提示SL(P=0.040)、满意减灭(P=0.014)均为独立预后因素;SL组死亡风险是USL组的0.566倍。结论:满意的减灭术有助于改善晚期卵巢癌患者的预后。对术中未发现腹膜后淋巴结肿大的患者,SL仍然可能改善患者的预后。Objective To explore the impact of systematic retroperitoneal lymphadenectomy（SL） in patients with advanced ovarian cancer. Methods The data on 188 patients with FIGO stage ⅢC epithelial ovarian cancer were retrospectively analyzed. All the patients underwent primary debulking surgery and then received platinum-based chemotherapy. The patients were divided into SL group and non-systematic lymphadenectomy（USL）group. Progression free survival（PFS） and overall survival（OS） times were analyzed. Results PFS and OS were higher in SL group than in USL group（36 versus 17 months and P = 0.022; 58 versus 52 months and P = 0.041）.Univariate analysis showed that both SL and optimal debulking surgery were the independent prognostic factors, but multivariate analysis indicated that optimal debulking surgery was the only independent prognostic factor. However,for 143 patients without enlarged retroperitoneal lymph nodes, multivariate analysis showed that either SL or optimal debulking surgery were the independent prognostic factor（P = 0.040 and P = 0.014）. Conclusions Optimal debulking surgery is helpful in improvement of the survival in patients with advanced ovarian cancer. For patients without enlarged retroperitoneal lymph nodes, SL still has a positive effect on the prognosis.

关 键 词：系统性淋巴结清扫 肿瘤细胞减灭术 卵巢癌 生存时间 

分 类 号：R737.31[医药卫生—肿瘤]