1st Department of Obstetrics and Gynaecology, Campus Innenstadt, Ludwig-Maximilians-University Munich, Munich, Germany.
BMC Cancer. 2010 May 21;10:224. doi: 10.1186/1471-2407-10-224.
During surgery for endometrial cancer, a pelvic lymphadenectomy with or without para-aortic lymphadenectomy is performed at least in patients with risk factors (stage I, grading 2 and/or histological subtypes with higher risk of lymphatic spread), and is hence recommended by the International Federation of Obstetrics and Gynecology (FIGO). Although lymph node metastases are important prognostic parameters, it has been contentious whether a pelvic lymph node dissection itself has a prognostic impact in the treatment of endometrial cancer, especially in endometrioid adenocarcinoma. Therefore, this study evaluated whether lymphadenectomy has a prognostic impact in patients with endometrioid adenocarcinoma.
The benefits of lymphadenectomy were examined in 214 patients with a histological diagnosis of endometrial adenocarcinoma. Tumour characteristics were analysed with respect to the surgical and pathological stage.
Of the 214 patients with endometrial adenocarcinoma, 171 (79.9%) were classified as FIGO stage I, 15 (7.0%) FIGO stage II, 21 (9.8%) FIGO stage III and 7 (3.3%) FIGO stage IV. One hundred and thirty four (62.6%) of the patients had a histological grade 1 tumour, while 56 (26.2%) and 24 (11.2%) had a histological grade 2 or grade 3 tumour, respectively. Lymphadenectomy was performed in 151 (70.6%) patients. Only 11 (5.1%) patients showed metastatic disease in the lymph nodes. The performance of a lymphadenectomy resulted in significantly increased cause-specific and overall survival, while progression-free survival was not affected by this operative procedure.
The performance of an operative lymphadenectomy resulted in better survival of patients with endometrioid adenocarcinoma. This increase was significant for cause-specific and overall survival, while there was a tendency only towards increased progression-free survival. Therefore, even in endometrioid adenocarcinoma, a pelvic and/or para-aortic lymphadenectomy should be performed.
在子宫内膜癌的手术中，至少在有风险因素的患者中（I 期、分级 2 和/或有更高淋巴扩散风险的组织学亚型）进行盆腔淋巴结切除术和/或腹主动脉旁淋巴结切除术，这是国际妇产科联合会（FIGO）推荐的。虽然淋巴结转移是重要的预后参数，但盆腔淋巴结清扫术本身是否对子宫内膜癌的治疗具有预后影响一直存在争议，特别是在子宫内膜样腺癌中。因此，本研究评估了淋巴结切除术在子宫内膜样腺癌患者中的预后影响。
对 214 例组织学诊断为子宫内膜腺癌的患者进行了淋巴结切除术的益处检查。对肿瘤特征进行了分析，包括手术和病理分期。
在 214 例子宫内膜腺癌患者中，171 例（79.9%）为 FIGO Ⅰ期，15 例（7.0%）为 FIGO Ⅱ期，21 例（9.8%）为 FIGO Ⅲ期，7 例（3.3%）为 FIGO Ⅳ期。134 例（62.6%）患者肿瘤组织学分级为 1 级，56 例（26.2%）和 24 例（11.2%）患者肿瘤组织学分级为 2 级或 3 级。151 例（70.6%）患者进行了淋巴结切除术。仅有 11 例（5.1%）患者的淋巴结有转移疾病。淋巴结切除术的实施显著提高了患者的特定原因生存率和总生存率，而无进展生存率不受该手术操作的影响。
施行手术性淋巴结切除术可提高子宫内膜样腺癌患者的生存率。这种增加在特定原因生存率和总生存率方面是显著的，而在无进展生存率方面仅存在增加的趋势。因此，即使在子宫内膜样腺癌中，也应进行盆腔和/或腹主动脉旁淋巴结切除术。
Zotero 插件
