Classe J-M, Cerato E, Boursier C, Dauplat J, Pomel C, Villet R, Cuisenier J, Lorimier G, Rodier J-F, Mathevet P, Houvenaeghel G, Leveque J, Lécuru F
Département de chirurgie oncologique, centre René-Gauducheau-ICO, boulevard Jean-Monod, Nantes-Saint-Herblain, France.
J Gynecol Obstet Biol Reprod (Paris). 2011 May;40(3):201-4. doi: 10.1016/j.jgyn.2011.02.009. Epub 2011 Apr 8.
The standard management for advanced-stage epithelial ovarian cancer is optimum cytoreductive surgery followed by platinum based chemotherapy. However, retroperitoneal lymph node resection remains controversial. The multiple directions of the lymph drainage pathway in ovarian cancer have been recognized. The incidence and pattern of lymph node involvement depends on the extent of the disease and the histological type. Several published cohorts suggest the survival benefit of pelvic and para-aortic lymphadenectomy. A recent large randomized trial have demonstrated the potential benefit for surgical removal of bulky lymph nodes in term of progression-free survival but failed to show any overall survival benefit because of a critical methodology. Further randomised trials are needed to balance risks and benefits of systematic lymphadenectomy in advanced-stage disease. CARACO is a French ongoing trial, built to bring a reply to this important question. A huge effort for inclusion of the patients, and involving new teams, are mandatory.
晚期上皮性卵巢癌的标准治疗方法是进行最佳细胞减灭术，随后进行铂类化疗。然而，腹膜后淋巴结切除术仍存在争议。卵巢癌淋巴引流途径的多方向性已得到认可。淋巴结受累的发生率和模式取决于疾病的范围和组织学类型。几项已发表的队列研究表明，盆腔和腹主动脉旁淋巴结清扫术对生存有益。最近一项大型随机试验表明，就无进展生存期而言，手术切除肿大淋巴结具有潜在益处，但由于关键方法问题，未显示出任何总生存期益处。需要进一步的随机试验来平衡晚期疾病系统性淋巴结清扫术的风险和益处。CARACO是法国正在进行的一项试验，旨在回答这个重要问题。必须做出巨大努力纳入患者并吸纳新的团队。
