腹主动脉旁淋巴结切除在子宫内膜癌治疗中的临床意义

Clinical significance of abdominal aortic lymph node resection in the treatment of endometrial carcinoma

目的探讨腹主动脉旁淋巴结切除在子宫内膜癌治疗中的意义及对患者预后的影响。方法选取2009年1月至2016年1月在湛江中心人民医院妇科行腹主动脉旁淋巴结切除的子宫内膜癌患者65例(观察组),同时选取未行腹主动脉旁淋巴结切除的子宫内膜癌患者78例(对照组),观察随访两组手术及预后情况。结果观察组手术时间、术中出血量、淋巴结阳性数均显著高于对照组(t值分别为4.84、4.77、13.53,均P<0.05),观察组有8例(12.31%)出现术中并发症和14例(21.54%)出现术后并发症,对照组有5例(6.41%)出现术中并发症和11(14.10%)例出现术后并发症,两组术中及术后并发症比较差异无统计学意义(χ~2值分别为1.492、1.359,均P>0.05)。两组随访率差异比较无统计学意义(χ~2=0.13,P>0.05)。观察组1年、3年和5年生存率分别为96.60%、73.70%和60.60%,对照组1年、3年和5年生存率分别为95.60%、69.80%和63.40%,两组生存曲线比较差异无统计学意义(χ~2=0.055,P>0.05)。结论子宫内膜癌治疗中行腹主动脉旁淋巴结切除是安全可行的,对手术病理分期和指导术后辅助治疗有重要意义,但对患者预后无明显影响。

Objective To investigate the significance of abdominal aortic lymph node resection in the treatment of endometrial carcinoma and its effect on the prognosis of patients. Methods From January 2009 to January 2016,65 patients with endometrial carcinoma in Zhanjiang People＇s Central Hospital who undergoing abdominal aortic lymph node resection（ observation group） were selected. At the same time,78 cases（ control group） of endometrial cancer not treated by abdominal aortic lymph node dissection were selected. Operation and prognosis were observed and followed up in two groups. Results The operation time,intraoperative blood loss and the number of positive lymph nodes in the observation group were significantly higher than those in the control group（ t value was 4. 84,4. 77 and 13. 53,respectively,all P〈0. 05）. In the observation group intraoperative complication occurred in 8 cases（ 12. 31%） and postoperative complications in 14 cases（ 21. 54%）,while in the control group intraoperative complication occurred in 5 cases（ 6. 41%） and postoperative complications in 11 cases（ 14. 10%）. The difference in two groups was not statistically significant（ χ^2value was 1. 492 and1. 359,respectively,both P〈0. 05）. The difference in follow-up rate was not statistically significant between two groups（ χ^2= 0. 13,P〈0. 05）. In the observation group 1 year survival rate,3 years survival rate and 5 years survival rates were 96. 60%,73. 70% and60. 60%,respectively,and in the control group 1 year survival rate,3 years survival rate and 5 years survival rates were 95. 60%,69. 80% and 63. 40%,respectively. The difference in survival curve was not statistically significant between two groups（ χ^2= 0. 055,P〈0. 05）. Conclusion Abdominal aortic lymph node resection is safe and effective in the treatment of endometrial cancer. It is of great significance for accurate surgical staging and postoperative adjuvant therapy,but has no significant effect on the prognosis of patients.