Pieterse Q D, Kenter G G, Gaarenstroom K N, Peters A A W, Willems S M, Fleuren G J, Trimbos J B M Z
Department of Gynaecology, K6-P, Leiden University Medical Center, PO Box 9600, Albinusdreef 2, 2300 RC Leiden, The Netherlands.
Eur J Surg Oncol. 2007 Mar;33(2):216-21. doi: 10.1016/j.ejso.2006.09.037. Epub 2006 Nov 13.
To determine if the number of removed lymph nodes in radical hysterectomy with lymphadenectomy (RHL) influences survival of patients with early stage cervical cancer and to analyze the relation of different factors like patient age, tumour size and infiltration depth with the number of nodes examined in node-negative early stage cervical cancer patients.
Of consecutive patients, who underwent RHL between January 1984 and April 2005, 331 had negative nodes (group A) without adjuvant therapy and 136 had positive nodes (group B). The Kaplan-Meier method and Cox regression model were used to detect statistical significance. Factors associated with excision of nodes were confirmed with linear regression models.
The median number of removed nodes was 19 and 18 for group A and group B, respectively. There was no significant relationship between the number of removed nodes and the cancer specific survival (CSS) or disease free survival (DSF) for patients of group A (p=0.625 and p=0.877, respectively). The number of removed nodes in group B was not significantly associated with the CSS (p=0.084) but it was for the DSF (p=0.014). Factors like patient age, tumour size and infiltration depth were not associated with the number of nodes.
No relation was found between the number of negative nodes examined after RHL for the treatment of early stage cervical cancer and CSS or DFS. However, a higher amount of removed lymph nodes leaded to a better DFS for patients with positive nodes. It is suggested that patients with positive nodes benefit from a complete pelvic lymphadenectomy and a sufficient yield of removed nodes.
确定根治性子宫切除术加淋巴结清扫术（RHL）中切除的淋巴结数量是否影响早期宫颈癌患者的生存率，并分析患者年龄、肿瘤大小和浸润深度等不同因素与淋巴结阴性的早期宫颈癌患者检查的淋巴结数量之间的关系。
在1984年1月至2005年4月期间接受RHL的连续患者中，331例淋巴结阴性（A组）且未接受辅助治疗，136例淋巴结阳性（B组）。采用Kaplan-Meier法和Cox回归模型检测统计学意义。用线性回归模型确定与淋巴结切除相关的因素。
A组和B组切除淋巴结的中位数分别为19个和18个。A组患者切除的淋巴结数量与癌症特异性生存率（CSS）或无病生存率（DSF）之间无显著关系（分别为p = 0.625和p = 0.877）。B组切除的淋巴结数量与CSS无显著相关性（p = 0.084），但与DSF有显著相关性（p = 0.014）。患者年龄、肿瘤大小和浸润深度等因素与淋巴结数量无关。
在RHL治疗早期宫颈癌后检查的阴性淋巴结数量与CSS或DFS之间未发现相关性。然而，切除更多的淋巴结可使淋巴结阳性患者的DFS更好。建议淋巴结阳性患者受益于完整的盆腔淋巴结清扫术和足够的切除淋巴结数量。
