Brown J V, Fu Y S, Berek J S
Department of Obstetrics and Gynecology, University of California, Los Angeles School of Medicine.
Obstet Gynecol. 1990 Oct;76(4):623-6.
Over a 32-year period at the University of California, Los Angeles Medical Center, all cases of adenocarcinoma and adenosquamous carcinoma of the uterine cervix were reviewed to determine the incidence of ovarian metastases in stage I disease. One of 25 patients (4.0%) who underwent an exploratory laparotomy and radical hysterectomy had a microscopic ovarian metastasis. A literature review identified nine additional patients who had ovarian metastases and stage I adenocarcinoma of the cervix. Including our series, the overall reported rate of ovarian metastases is 1.8%. All ten patients had at least one of the following additional characteristics: They were postmenopausal, they had adnexal pathology, or they had positive pelvic lymph nodes. Thus, ovarian preservation is warranted in premenopausal patients who do not have ovarian pathology or evidence of other metastatic disease at surgery. Bilateral oophorectomy may be performed if frozen-section examination of enlarged or suspicious nodes documents metastases. If the ovaries are left in the pelvis at the completion of the surgical procedure and microscopic spread to other pelvic tissues is documented, pelvic irradiation can be administered.
在加利福尼亚大学洛杉矶分校医学中心的32年期间，对所有子宫颈腺癌和腺鳞癌病例进行了回顾，以确定I期疾病中卵巢转移的发生率。在接受剖腹探查和根治性子宫切除术的25例患者中，有1例（4.0%）存在微小卵巢转移。文献回顾发现另外9例患有卵巢转移和I期子宫颈腺癌的患者。包括我们的系列病例在内，报告的卵巢转移总体发生率为1.8%。所有10例患者至少具有以下额外特征之一：她们已绝经、有附件病变或盆腔淋巴结阳性。因此，对于手术时没有卵巢病变或其他转移疾病证据的绝经前患者，保留卵巢是合理的。如果对肿大或可疑淋巴结的冰冻切片检查证实有转移，则可进行双侧卵巢切除术。如果在手术结束时将卵巢留在盆腔内，且记录到有微小扩散至其他盆腔组织的情况，则可进行盆腔放疗。
