[腹膜后淋巴结切除术对上皮性卵巢癌患者生存率的影响]

[Effect of retroperitoneal lymphadenectomy on survival of patients with epithelial ovarian cancer].

作者信息

Xiong Zhou-fang, Wang Ze-hua, Wang Shi-xuan

机构信息

Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2003 Feb;38(2):77-80.

PMID:12783692

Abstract

OBJECTIVE

The purpose of this study was to determine prognostic factors that have an impact on overall survival and to assess the rational application of retroperitoneal lymphadenectomy in patients with epithelial ovarian cancer.

METHODS

A retrospective review was performed of 131 patients treated between Jan.1990 and Dec.1998 in Union Hospital and Tongji Hospital. Survival was calculated by Kaplan-Meier method and comparison was performed using Log-rank test. Independent prognostic factors were identified by the COX proportional hazards regression model.

RESULTS

Multivariate analysis showed that the age, stage, residual tumor, retroperitoneal lymphadenectomy and the number of courses of chemotherapy were the most important prognostic factors. The overall 5-year survival was 66% and 41% for patients who did and did not undergo lymphadenectomy, respectively (P < 0.01). But the survival rate could not be improved through retroperitoneal lymphadenectomy in the patients with early stage, advanced stage whose residual tumor > 2 cm and those with mucinous adenocarcinoma (P > 0.05). Among patients with advanced stage whose residual tumor < or = 2 cm, 5-year survival was 65% and 30% for patients who did and did not undergo lymphadenectomy, respectively (P < 0.01). Among patients with serous adenocarcinoma, 5-year survival was 61% and 31% for patients who did and did not undergo lymphadenectomy, respectively (P < 0.01).

CONCLUSIONS

The prognosis of the patients with epithelial ovarian cancer may be influenced by age, stage, residual tumor, retroperitoneal lymphadenectomy and the number of courses of chemotherapy. Although retroperitoneal lymphadenectomy could improve the survival rate, it should be carried out selectively.

摘要

目的

本研究旨在确定影响总生存期的预后因素，并评估上皮性卵巢癌患者腹膜后淋巴结切除术的合理应用。

方法

对1990年1月至1998年12月在协和医院和同济医院接受治疗的131例患者进行回顾性分析。采用Kaplan-Meier法计算生存率，并使用Log-rank检验进行比较。通过COX比例风险回归模型确定独立预后因素。

结果

多因素分析显示，年龄、分期、残留肿瘤、腹膜后淋巴结切除术及化疗疗程数是最重要的预后因素。接受和未接受淋巴结切除术患者的5年总生存率分别为66%和41%（P<0.01）。但早期、残留肿瘤>2cm的晚期及黏液性腺癌患者行腹膜后淋巴结切除术不能提高生存率（P>0.05）。残留肿瘤≤2cm的晚期患者中，接受和未接受淋巴结切除术患者的5年生存率分别为65%和30%（P<0.01）。浆液性腺癌患者中，接受和未接受淋巴结切除术患者的5年生存率分别为61%和31%（P<0.01）。