Department of Gynecologic Oncology, AC Camargo Cancer Hospital, Sao Paulo, Brazil.
J Surg Oncol. 2011 Sep 1;104(3):250-4. doi: 10.1002/jso.21940. Epub 2011 Apr 6.
Studies addressing mesenteric and mesocolic lymph node metastasis in patients with advanced ovarian cancer that have undergone bowel resection are lacking.
A retrospective analysis was performed in a series of 50 individuals who underwent surgical cytoreduction for epithelial ovarian cancer that included bowel resection from April 2004 to September 2010.
Forty-one patients had bowel resection with mesenteric lymph nodes that were suitable for analysis. Twenty-four (58.5%) patients underwent retosigmoidectomies, 14 (34.1%) received other types of colectomies, and three (7.3%) underwent small bowel resection. There was serosal involvement in 14 cases (34.1%), muscularis propria invasion in 13 cases (31.7%), submucosa invasion in six cases (14.6%), and mucosa in eight cases (19.5%). Lymphatic invasion was observed in 24 patients (58.5%). A median of 14 mesenteric lymph nodes were analyzed. Metastatic lymph nodes were observed in 29 (70.7%) cases. Invasion into the muscularis propria (P = 0.036), lymphatic invasion (P = 0.045), and retroperitoneal lymph node metastasis (P = 0.002) correlated significantly with mesenteric lymph node involvement.
Resection of regional lymph nodes of affected organs that is similar to surgical procedures that are performed for colorectal carcinoma is an appropriate, optimal debulking surgery for patients with ovarian carcinoma.
缺乏针对接受肠切除术的晚期卵巢癌患者肠系膜和结肠系膜淋巴结转移的研究。
对 2004 年 4 月至 2010 年 9 月期间接受手术减瘤的上皮性卵巢癌患者进行了一项回顾性分析，这些患者接受了肠切除术。
50 例患者中有 41 例接受了肠系膜淋巴结清扫术，且适合进行分析。24 例（58.5%）患者行乙状结肠切除术，14 例（34.1%）接受其他类型的结肠切除术，3 例（7.3%）行小肠切除术。14 例（34.1%）有浆膜受累，13 例（31.7%）有固有肌层侵犯，6 例（14.6%）有黏膜下层侵犯，8 例（19.5%）有黏膜侵犯。24 例（58.5%）有淋巴管侵犯。分析了中位数为 14 个肠系膜淋巴结。29 例（70.7%）观察到转移淋巴结。固有肌层侵犯（P=0.036）、淋巴管侵犯（P=0.045）和腹膜后淋巴结转移（P=0.002）与肠系膜淋巴结受累显著相关。
对于卵巢癌患者，类似结直肠癌手术的受累器官区域淋巴结切除术是一种合适的、最佳的减瘤手术。
