Department of Gynaecology, Hopital Tenon, 4 Rue de la Chine,Paris, France.
BJOG. 2010 Nov;117(12):1451-8. doi: 10.1111/j.1471-0528.2010.02633.x.
The therapeutic role of lymphadenectomy on the survival in patients with ovarian cancer is controversial. The aim of this study was to evaluate the survival impact of lymphadenectomy, depending on the disease stage and extent of the surgery.
The surveillance, epidemiology, and end results (SEER) registry provided ovarian cancer data from 17 registries.
Surveillance, Epidemiology, and End Results database.
The study population comprised 49,783 patients.
Survival was studied according to the number of lymph nodes removed, with stratifications on disease stage and extent of surgery.
The 5-year cause-specific survival rate.
The median follow up for patients alive at the last follow-up visit was 39 months. The five-year cause-specific survival rates were 37, 62, and 71% for the groups in which no lymph nodes were examined, in which between one and nine nodes were examined, and in which ten or more nodes were examined, respectively (P< 0.001). Avoiding lymphadenectomy was deleterious in all stages of the disease. It was maximal for International Federation of Gynecology and Obstetrics (FIGO) stage-II patients, but there was no significant interaction between stage and extent of lymphadenectomy. The cause-specific survival was found to significantly increase when more nodes were resected, even if the surgical procedure consisted of debulking surgery or a pelvic exenteration.
Our study suggests a beneficial effect of lymphadenectomy in epithelial ovarian tumours, regardless of the stage of disease and extent of surgery. However, potential biases inherent to this retrospective methodology, such as staging migration, defining the extent of residual disease, and the possibility that thorough lymphadenectomy may reflect the quality of cytoreductive surgery, preclude any formal conclusions on the therapeutic role of lymphadenectomy.
淋巴结切除术对卵巢癌患者生存的治疗作用存在争议。本研究旨在评估淋巴结切除术对生存的影响，取决于疾病的分期和手术的范围。
监测、流行病学和最终结果（SEER）登记处提供了来自 17 个登记处的卵巢癌数据。
监测、流行病学和最终结果数据库。
研究人群包括 49783 名患者。
根据切除的淋巴结数量研究生存情况，并对疾病分期和手术范围进行分层。
5 年特异性生存率。
在最后一次随访时存活的患者的中位随访时间为 39 个月。未检查淋巴结、检查 1 至 9 个淋巴结和检查 10 个或更多淋巴结的患者的 5 年特异性生存率分别为 37%、62%和 71%（P<0.001）。避免淋巴结切除术对疾病的所有阶段都是有害的。对于国际妇产科联合会（FIGO）分期 II 期的患者最为明显，但分期和淋巴结切除术范围之间没有显著的相互作用。即使手术是减瘤手术或盆腔廓清术，切除更多的淋巴结也会显著提高特异性生存率。
我们的研究表明，淋巴结切除术对上皮性卵巢肿瘤有益，无论疾病的分期和手术范围如何。然而，这种回顾性方法固有的潜在偏倚，如分期迁移、定义残留疾病的范围以及彻底的淋巴结切除术可能反映细胞减灭术的质量，排除了对淋巴结切除术治疗作用的任何正式结论。
