University Clinical Department of Gynecology and Perinatology, University Clinical Centre Maribor, Maribor, Slovenia.
Eur J Obstet Gynecol Reprod Biol. 2010 Aug;151(2):208-11. doi: 10.1016/j.ejogrb.2010.04.011. Epub 2010 May 10.
To evaluate the differences in number of harvested retroperitoneal pelvic lymph nodes by specific lymph node regions in respect to pelvic laterality.
We extracted cases of early ovarian cancer (EOC) with lymphadenectomy from the medical database which were treated at our institution in the period between 1994 and 2008. Recommendations of FIGO and EGSOC (European Guidelines for Staging in Ovarian Cancer) for staging of ovarian malignancies were followed. Stage of the disease was established on the basis of intra-abdominal condition which we found during surgery and histopathologic status of retroperitoneal lymph nodes (LN). For each case and every LN group, we subtracted the number of dissected lymph nodes on the left side from the number of dissected lymph nodes on the right side of the pelvis. The result would represent the difference between number of removed LN on each side of the pelvis for specific LN group. A negative difference means that a greater number of LN was extracted from the left side and a positive difference that the greater number of LN was extracted from the right side of the pelvis. We used Wilcoxon signed-rank test for statistical analysis of differences.
48 cases with EOC underwent lymphadenectomy. In three cases, metastatic retroperitoneal pelvic lymph nodes were found. There were 79.1%, 50.0%, 45.8%, 93.8%, 52.1%, 60.4% and 70.8% of cases with left-right difference in number of removed lymph nodes in external iliac region, common iliac region, presacralic, above obturator nerve, under obturator nerve, lateral from the external ilac vessels and lateral from the common iliac vessels nodal group, respectively. The mean differences between left and right groups were in the range from 2 to 4 lymph nodes. There was no identifiable bias toward either side of the pelvis for any of the analyzed lymph node groups.
There is a right and left prevalence of retrieved LN by individual LN regions in the pelvis that could be influenced by asymmetry in right-left pelvic LN distribution. However, we did not find any evidence that the observed imbalance is, on average, directed toward either side of the pelvis.
评估特定腹膜后盆腔淋巴结区域的淋巴结采集数量在盆腔侧别的差异。
我们从我们机构在 1994 年至 2008 年期间治疗的早期卵巢癌（EOC）患者的医学数据库中提取了淋巴结切除术病例。遵循 FIGO 和 EGSOC（欧洲卵巢癌分期指南）对卵巢恶性肿瘤分期的建议。疾病分期基于我们在手术中发现的腹腔内情况和腹膜后淋巴结（LN）的组织病理学状态。对于每个病例和每个 LN 组，我们从骨盆右侧解剖的淋巴结数量中减去骨盆左侧解剖的淋巴结数量。结果将代表特定 LN 组骨盆两侧切除的 LN 数量之间的差异。负差异表示从左侧提取了更多的 LN，正差异表示从骨盆右侧提取了更多的 LN。我们使用 Wilcoxon 符号秩检验进行统计分析差异。
48 例 EOC 患者行淋巴结切除术。在三种情况下，发现了转移性腹膜后盆腔淋巴结。外部髂区、总髂区、骶前区、闭孔神经上方、闭孔神经下方、髂外血管旁和髂总血管旁淋巴结组中，左侧和右侧淋巴结切除数量差异的病例分别为 79.1%、50.0%、45.8%、93.8%、52.1%、60.4%和 70.8%。左侧和右侧组之间的平均差异在 2 至 4 个淋巴结之间。对于分析的任何一个淋巴结组，骨盆两侧均无明显偏向。
骨盆内各个淋巴结区域的 LN 采集存在左右侧的优势，这可能受到骨盆左右侧 LN 分布的不对称性影响。然而，我们没有发现任何证据表明观察到的不平衡平均偏向骨盆的任何一侧。
