Objective. To investigate the lymph node sites most susceptible to involvement relative to primary tumor histology in ovarian cancer. Methods. The locations of metastatic lymph nodes were investigated in 208 patients ...Objective. To investigate the lymph node sites most susceptible to involvement relative to primary tumor histology in ovarian cancer. Methods. The locations of metastatic lymph nodes were investigated in 208 patients with primary ovarian cancer who underwent systemic lymphadenectomy covering both the pelvic and para-aortic regions. Results. Lymph node metastasis was present in 12.8%(20/156) of patients with stage I (pT1M0), 48.6%(18/37) with stage II (pT2M0), and 60%(9/15) with stage III (pT3M0) disease, thus in 22.6%(47/208) of all study patients. Isolated para-aortic nodal involvement was present in 23.3%(14/60) of patients with serous tumor and 4.1%(6/148)-of those with non-serous tumor (P = 0.00002). In an analysis of 35 positive nodes from 25 patients with up to 3 positive nodes, 86.4%(19/22) of metastatic lymph nodes from patients with serous tumor were found in the para-aortic region, with 14 positive nodes located above the inferior mesenteric artery (IMA) and 5 below it, whereas metastasis to para-aortic lymph nodes accounted for 53.8%(7/13) of metastatic lymph nodes from patients with non-serous tumor (P = 0.0334). Conclusions. The locations of metastatic lymph nodes in ovarian cancer depend upon the histologic type of the primary cancer. In cases of serous tumor, the para-aortic region, particularly above the IMA, is the prime site for the earliest lymph node metastasis. However, the likelihood of pelvic node involvement is almost equal to that of para-aortic node involvement in cases of nonserous tumor.展开更多
目的分析卵巢非侵袭性低级别浆液性癌（low-grade serous carcinoma,LGSC）患者保留生育功能手术的特点。方法回顾性收集2015年1月至2015年6月北京协和医院病理诊断为卵巢非侵袭性LGSC且进行保留生育功能手术的患者,对其临床病理特点、...目的分析卵巢非侵袭性低级别浆液性癌（low-grade serous carcinoma,LGSC）患者保留生育功能手术的特点。方法回顾性收集2015年1月至2015年6月北京协和医院病理诊断为卵巢非侵袭性LGSC且进行保留生育功能手术的患者,对其临床病理特点、手术过程和随访情况进行总结。结果共有5例非侵袭性LGSC且保留生育功能患者,中位年龄29岁（24~34岁）;1例行开腹手术,4例行腹腔镜手术;4例手术行卵巢囊肿剔除,1例患者因为卵巢急性扭转坏死行受累附件切除。1例国际妇产科联盟（International Federation of Gynecology and Obstetrics,FIGO）分期为IB期,4例为IA期。所有患者术后均未接受进一步治疗。中位随访7个月（6~12个月）,所有患者均未复发,1例患者自然受孕且母胎情况良好。结论对于非侵袭性LGSC患者,能否保留生育功能、保留生育功能手术术后的生育情况、复发率及随诊方案,仍是目前临床处理的棘手问题。本研究为年轻的非侵袭性LGSC患者提供了保留卵巢的选择,但患者的长期预后（包括生育和生存）尚有待进一步随访。展开更多
文摘Objective. To investigate the lymph node sites most susceptible to involvement relative to primary tumor histology in ovarian cancer. Methods. The locations of metastatic lymph nodes were investigated in 208 patients with primary ovarian cancer who underwent systemic lymphadenectomy covering both the pelvic and para-aortic regions. Results. Lymph node metastasis was present in 12.8%(20/156) of patients with stage I (pT1M0), 48.6%(18/37) with stage II (pT2M0), and 60%(9/15) with stage III (pT3M0) disease, thus in 22.6%(47/208) of all study patients. Isolated para-aortic nodal involvement was present in 23.3%(14/60) of patients with serous tumor and 4.1%(6/148)-of those with non-serous tumor (P = 0.00002). In an analysis of 35 positive nodes from 25 patients with up to 3 positive nodes, 86.4%(19/22) of metastatic lymph nodes from patients with serous tumor were found in the para-aortic region, with 14 positive nodes located above the inferior mesenteric artery (IMA) and 5 below it, whereas metastasis to para-aortic lymph nodes accounted for 53.8%(7/13) of metastatic lymph nodes from patients with non-serous tumor (P = 0.0334). Conclusions. The locations of metastatic lymph nodes in ovarian cancer depend upon the histologic type of the primary cancer. In cases of serous tumor, the para-aortic region, particularly above the IMA, is the prime site for the earliest lymph node metastasis. However, the likelihood of pelvic node involvement is almost equal to that of para-aortic node involvement in cases of nonserous tumor.
文摘目的分析卵巢非侵袭性低级别浆液性癌（low-grade serous carcinoma,LGSC）患者保留生育功能手术的特点。方法回顾性收集2015年1月至2015年6月北京协和医院病理诊断为卵巢非侵袭性LGSC且进行保留生育功能手术的患者,对其临床病理特点、手术过程和随访情况进行总结。结果共有5例非侵袭性LGSC且保留生育功能患者,中位年龄29岁（24~34岁）;1例行开腹手术,4例行腹腔镜手术;4例手术行卵巢囊肿剔除,1例患者因为卵巢急性扭转坏死行受累附件切除。1例国际妇产科联盟（International Federation of Gynecology and Obstetrics,FIGO）分期为IB期,4例为IA期。所有患者术后均未接受进一步治疗。中位随访7个月（6~12个月）,所有患者均未复发,1例患者自然受孕且母胎情况良好。结论对于非侵袭性LGSC患者,能否保留生育功能、保留生育功能手术术后的生育情况、复发率及随诊方案,仍是目前临床处理的棘手问题。本研究为年轻的非侵袭性LGSC患者提供了保留卵巢的选择,但患者的长期预后（包括生育和生存）尚有待进一步随访。
