不同术式治疗早期卵巢颗粒细胞瘤的预后分析

Analysis of the Prognosis of Early-stage Granulosa Cell Tumours by Different Operative Methods

目的:探讨不同术式对早期卵巢颗粒细胞瘤初治患者预后的影响。方法:收集2000年1月～2008年12月我院收治的39例早期卵巢颗粒细胞瘤患者的临床资料,分析不同术式对肿瘤复发和预后的影响。结果:39例患者中,行全面分期手术者20例,其中7例仅予盆腔及腹主动脉旁淋巴结活检而未予淋巴结清扫,所有淋巴结术后病理皆提示无淋巴转移;19例行非全面分期手术。随访期间,全面分期手术组皆无复发,而非全面分期手术组4例复发,两组患者术后3年的复发率分别为0和21%,具有统计学差异(P<0.05);非全面分期手术组有1例患者于术后29月死亡,死亡年龄为72岁,全面分期手术组无死亡病例,两组患者的死亡率不具有统计学差异(P>0.05)。结论:原发性卵巢颗粒细胞瘤罕有淋巴结转移,早期卵巢颗粒细胞瘤行全面分期手术对于明确肿瘤分期、治疗及预后有重要意义,而全面分期手术中行盆腔及腹主动脉旁淋巴结清扫对于肿瘤的复发意义有限,初治患者全面分期手术时可不予淋巴清扫。

Objective： To evaluate the effect of different operative methods on the prognosis of early-stage（stages I-II） Granulosa tumors（GCTs）.Methods： The clinical data of 39 cases of early-stage GCTs hospitalized from January 2000 to December 2008 were selected to analyze the role of different operative methods in the prognosis and relapse of patients.Results： In all 39 cases,20 cases underwent complete staging operation,of which 7 cases underwent Lymph node biopsy without lymph node dissection,and none lymph node metastasis had been found;19 cases did not undergo complete staging operation.During follow-up period,no recurrence had been observed in patients that underwent complete staging operation,including patients without lymph node dissection,however,recurrence was observed in 4 of 19 cases who did not undergo complete staging operation.The recurrence rates of patients with and without complete staging operation,including patients without lymph node,were respectively 0 % and 21 %（P0.05）.No death was found in patients with complete staging operation,1 of 19 patients who aged 72 years did not undergo complete staging operation,and died 29 months after operation（P0.05）.Conclusion： Lymph node metastasis was rare in early-stage Granulosa cell tumours,complete staging operation played an important role in distinguishing stages,treatment and improving prognosis.Routine lymphadenectomy provided limited additional information in the management of Early-stage GCTs and could be omitted from the primary surgical staging procedure.