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Significance of systematic retroperitoneal lymphadenectomy at second-look laparotomy for ovarian cancer
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OBSTETRICS AND GYNECOLOGY
- Issue:
- 2
- DOI:
- 10.3760/j.issn:0529-567X.2003.02.002
- Key Word:
- 卵巢肿瘤;剖腹术;淋巴结切除术;再手术
Abstract： 目的探讨卵巢恶性肿瘤腹膜后淋巴结清除术的最佳时机和临床价值.方法回顾性分析了50例二次剖腹探查术(SLL)中行腹膜后淋巴结清除术的卵巢恶性肿瘤患者的临床资料.结果患者中位数年龄49岁,其3年和5年生存率分别为72%和62%.SLL阳性率为40%(20/50),其中临床分期[国际妇产科联盟(FIGO)标准]Ⅰ期SLL阳性率为0%(0/15),Ⅱ期和Ⅲ期分别为40% (4/10)、62%(15/24),Ⅳ期为1例中1例.SLL阳性率与临床分期的期别呈正相关,其中Ⅰ～Ⅱ期(16%,4/25)和Ⅲ～Ⅳ期(64%,16/25)患者SLL阳性率比较,差异有极显著性(P<0.01).腹膜后淋巴结转移率为32%(16/50),其中Ⅰ、Ⅱ、Ⅲ期分别为0%(0/15)、20%(2/10)、54%(13/24),Ⅳ期为1例中1例.SLL阳性患者中,4例(8%)仅盆腹腔内有转移灶,淋巴结无转移;6例(12%)仅显微镜下淋巴结转移,而无盆腹腔转移灶.SLL中,行二次肿瘤细胞减灭术共20例,其中术后13例残留灶直径≤0.5 cm,7例残留灶直径>0.5 cm.中位数随访时间44个月(24～104个月),至随访截止日SLL阴性者(30例)均无肿瘤复发.结论腹膜后淋巴结清除术在SLL术中进行比较合理,而且对降低SLL阴性患者的复发率和提高卵巢恶性肿瘤的5年生存率有一定的临床价值.
- [1]臧荣余,蔡树模,张志毅.晚期卵巢上皮性癌化学药物治疗的意义及远期疗效的影响因素[J].2001,(12).
- [2]Angiolo Gadducci,Enrico Sartori,Tiziano Maggino,etc.Analysis of Failures after Negative Second-Look in Patients with Advanced Ovarian Cancer: An Italian Multicenter Study[J].1998,68(2).
- [3]R L, Friedman,S M, Eisenkop,H J, Wang.Second-look laparotomy for ovarian cancer provides reliable prognostic information and improves survival.[J].1997,67(1).
- [4]W T, Creasman.Second-look laparotomy in ovarian cancer.[J].1994,55(3 Pt 2).
- [5]K C, Podratz,G D, Malkasian,H S, Wieand,etc.Recurrent disease after negative second-look laparotomy in stages III and IV ovarian carcinoma.[J].1988,29(3).
- [6]S A, Cannistra.Cancer of the ovary.[J].1993,329(21).
- [7]Gabriela Baiocchi,Giuseppe Grosso,Emanuela di Re,etc.Systematic Pelvic and Paraaortic Lymphadenectomy at Second-Look Laparotomy for Ovarian Cancer[J].1998,69(2).
- [8]Pao-Chen Wu,Jing-Yi Qu,Jing-He Lang,etc.Lymph node metastasis of ovarian cancer: A preliminary survey of 74 cases of lymphadenectomy[J].1986,155(5).
- [9]G, Bolis,A, Villa,P, Guarnerio,etc.Survival of women with advanced ovarian cancer and complete pathologic response at second-look laparotomy.[J].1996,77(1).