盆腔和低位腹主动脉旁淋巴结清扫对国际妇产科联盟分期Ⅰ期子宫内膜样癌患者的安全性和预后的影响

Effect of pelvic and low paraaortic lymph node dissection on the safety and prognosis on the international federation of gynecology and obstetrics stageⅠendometrioid carcinoma

目的探讨盆腔和低位腹主动脉旁淋巴结清扫术对国际妇产科联盟(FIGO)分期Ⅰ期子宫内膜样癌患者疗效及预后的影响。方法回顾性分析2018年1月至2020年1月中国人民解放军联勤保障部队第910医院收治的81例接受手术治疗的早期子宫内膜样癌患者的临床资料。根据患者淋巴结清扫方法不同分为盆腔淋巴结清扫(PLD)组(n=44)和低位腹主动脉旁淋巴结清扫(PALD)+PLD组(n=37)。比较两组的手术相关资料、术后1年复发率、3年总生存率及并发症发生情况。结果PALD+PLD组的手术时间显著长于PLD组,淋巴结清扫数和阳性淋巴结数显著大于PLD组(P<0.05)。两组术中、术后并发症发生率比较,差异无统计学意义(P>0.05)。两组1年内复发率比较,差异具有统计学意义(P<0.05)。两组3年总生存率比较,差异无统计学意义(P>0.05)。结论盆腔和低位腹主动脉旁淋巴结清扫术可降低FIGO分期Ⅰ期子宫内样膜癌患者的复发率,且不会提高手术并发症发生率。

Objective To investigate the effect of pelvic and low paraaortic lymph node dissection on the efficacy and prognosis on the international federation of gynecology and obstetrics(FIGO)stageⅠendometrioid carcinoma patients.Methods A retrospective analysis was conducted on the clinical data of 81 patients with early endometrioid carcinoma who underwent surgical treatment at No.910th Hospital of the Joint Service Support Force of the People′s Liberation Army from January 2018 to January 2020.According to different lymphadenectomy methods,patients were divided into a pelvic lymphadenectomy(PLD)group(n=44)and a low para-aortic lymph node dissection(PALD)+PLD group(n=37).The surgery-related data,recurrence rate within 1 year,overall survival rate at 3 years,and complications condition in both groups were compared.Results The operation time in the PALD+PLD group was significantly longer than that in the PLD group,and the numbers of resected lymph nodes and positive lymph nodes were significantly higher than those in the PLD group(P<0.05).There was no significant difference in the incidence of intraoperative and postoperative complications between the two groups.The recurrence rate within 1 year was significantly different between the two groups(P<0.05).There was no significant difference in the overall survival rate at 3 years between the two groups(P>0.05).Conclusions Pelvic and low paraaortic lymph node dissection can reduces the recurrence rate in FIGO stageⅠendometrioid carcinoma patients without increasing the incidence of surgical complications.