宫颈癌淋巴结切除适应证和争议

Indications and controversies of lymphadenectomy in cervical cancer

NCCN和FIGO指南对淋巴结切除适应证做出推荐,但就宫颈癌淋巴结切除仍存在争议点。对于局部晚期宫颈癌行手术分期是安全可行的。前哨淋巴结切除术目前尚不能替代系统性淋巴结切除术。对于ⅠA2~ⅡA2期宫颈癌,建议行腹主动脉旁淋巴结取样术,上界达肠系膜下动脉水平足够。有转移肿大的淋巴结建议手术切除。

The indication of lymphadenectomy has been recommended by NCCN guideline and FIGO guideline.However,there is controversy in lymphadenectomy for cervical cancer.Surgical staging of women with locally advanced cervical cancer is feasible and safe.Sentinel lymph node dissection could not replace systematic lymphadenectomy nowadays.Para-aortic lymph node dissection is recommended for ⅠA2~ⅡA2 cervical cancer patients.The level of para-aortic lymph node dissection,up to inferior mesenteric artery,is enough.The dissection of enlarged and metastatic lymph nodes is recommended.