晚期卵巢上皮性癌腹膜后淋巴结清除的合理选择

A Rational Selection of Retroperitoneal Lymphadenectomy for Advanced Epithelial Ovarian Cancer

目的探讨腹膜后淋巴结清除术在晚期卵巢上皮性癌治疗中的合理应用。方法对４２例晚期卵巢上皮性癌行腹膜后淋巴结清除术，根据术后残留灶大小分成两组。Ａ组：２６例，残留癌灶直径＜２ｃｍ；Ｂ组：１６例，残留癌灶直径≥２ｃｍ。术后两组进行的联合化疗基本相同。临床分期和病理分级基本相同。结果Ａ组５年生存率５３８％（１４／２６），Ｂ组５年生存率１２５％（２／１６），两组比较，差异有极显著意义（Ｐ＜０．００１）。结论晚期卵巢上皮性癌在残留癌灶直径＜２ｃｍ前提下行腹膜后淋巴结清除术，可以明显提高生存率。如残留癌灶直径≥２ｃｍ时，不必行腹膜后淋巴结清除术。

Objective To evaluate the rational application of retroperitoneal lymphadenectomy to advanced epithelial ovarian cancer. Methods 42 patients of advanced epithelial ovarian cancer were treated by retroperitoneal lymphadenectomy. Two groups were divided according to the residual disease post operation. A:26 patients with the residual disease <2 cm; B:16 patients≥2 cm. The regime of combined chemotherapy was the same in the two groups after operation. Clinical stage and pathologic grade showed no difference. Results The 5 year survival rate was 53.8% (14/26) in A and 12.5%(2/16) in B. There was a significant difference between the two groups ( P <0.001). Conclusions The survival rate could be greatly improved for advanced epithelial ovarian cancer through retroperitoneal lymphadenectony when the residual disease was smaller than 2 cm. This procedure would not be performed if the residual disease was larger than or equal to 2 cm.