Hidaka Takao, Nakashima Akitoshi, Shima Tomoko, Hasegawa Toru, Saito Shigeru
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan.
Obstet Gynecol Int. 2010;2010:490219. doi: 10.1155/2010/490219. Epub 2010 Feb 4.
Objective. The objective of this study is to ascertain whether omission of lymphadenectomy could be possible when uterine corpus cancer is considered low-risk based on intraoperative pathologic indicators. Patient and Methods. Between 1998 and 2007, a total of 83 patients with low risk corpus cancer (endometrioid type, grade 1 or 2, myometrial invasion <==50%, and no intraoperative evidence of macroscopic extrauterine spread, including pelvic and paraaortic lymph node swelling and adnexal metastasis) underwent the total abdominal hysterectomy and bilateral salpingo-oophorectomy without lymphadenectomy. A retrospective review of the medical records was performed, and the disease-free survival (DFS), overall survival (OS), peri- and postoperative morbidities and complications were evaluated. Results. The 5-year DFS rates and the 5-year OS rates were 97.6% and 98.8%, respectively. No patient presented postoperative leg lymphedema and deep venous thrombosis. Conclusion. Omission of lymphadenectomy did not worsen the DFS or OS. The present findings suggest that systemic lymphadenectomy could be omitted in low-risk endometrial carcinoma.
目的。本研究的目的是确定当基于术中病理指标认为子宫体癌为低风险时，是否可以省略淋巴结切除术。患者与方法。1998年至2007年间，共有83例低风险子宫体癌患者（子宫内膜样型，1级或2级，肌层浸润<=50%，且术中无肉眼可见的子宫外播散证据，包括盆腔和腹主动脉旁淋巴结肿大及附件转移）接受了全腹子宫切除术和双侧输卵管卵巢切除术，未进行淋巴结切除术。对病历进行了回顾性分析，并评估了无病生存期（DFS）、总生存期（OS）、围手术期和术后发病率及并发症。结果。5年DFS率和5年OS率分别为97.6%和98.8%。无患者出现术后腿部淋巴水肿和深静脉血栓形成。结论。省略淋巴结切除术并未使DFS或OS恶化。目前的研究结果表明，低风险子宫内膜癌可省略系统性淋巴结切除术。
