Gao Y, Yu A, Chen L
Department of Gynecologic Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China.
Zhonghua Fu Chan Ke Za Zhi. 2000 May;35(5):264-6.
To explore the therapeutic value of pelvic lymphadenectomy for endometrial carcinoma.
One hundred and four cases undergoing pelvic lymphadenectomy were analyzed. Comparisons were carried out between various clinicopathologic factors and incidence of positive node, between 5 years survival rate with pelvic lymphadenectomy and that without pelvic lymphadenectomy.
Four point four per cent case with positive node was found in clinical stage I cases. Positive node rate increased with deep myoinvasion and G3, accounting for 37.3% and 37.8% respectively. For clinical stage I and stage II cases, the 5 year survival rate of positive node and negative node was 38.9% and 74.2% respectively, with significant difference (P < 0.005). No significant difference was found between cases with pelvic lymphadenectomy and those without pelvic lymphadenectomy (P > 0.05) in pathologic stage I and stage II cases.
Positive pelvic node is an important prognostic factor in endometrial carcinoma. Pelvic lymphadenectomy can not improve prognosis in early stage patients with endometrial carcinoma. It is not necessary to perform pelvic lymphadenectomy for stage I case, because of low incidence of positive node.
探讨盆腔淋巴结切除术对子宫内膜癌的治疗价值。
分析104例行盆腔淋巴结切除术的病例。对各种临床病理因素与淋巴结阳性发生率之间、行盆腔淋巴结切除术与未行盆腔淋巴结切除术的患者5年生存率之间进行比较。
临床Ⅰ期病例中发现淋巴结阳性率为4.4%。淋巴结阳性率随肌层浸润深度增加及病理分级为G3而升高，分别占37.3%和37.8%。对于临床Ⅰ期和Ⅱ期病例，淋巴结阳性和阴性患者的5年生存率分别为38.9%和74.2%，差异有统计学意义（P<0.005）。在病理Ⅰ期和Ⅱ期病例中，行盆腔淋巴结切除术与未行盆腔淋巴结切除术的患者之间差异无统计学意义（P>0.05）。
盆腔淋巴结阳性是子宫内膜癌重要的预后因素。盆腔淋巴结切除术不能改善早期子宫内膜癌患者的预后。对于Ⅰ期病例，由于淋巴结阳性发生率低，不必行盆腔淋巴结切除术。
