Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, No, 7, Chung Shan South Road, Taipei 10002, Taiwan.
World J Surg Oncol. 2013 Oct 3;11:255. doi: 10.1186/1477-7819-11-255.
Neck lymph node metastasis (NLNM) in epithelial ovarian cancer (EOC) is rare and treated as advanced stage cancer. However, ovarian cancer with lymphatic metastasis may manifest a different clinical course from peritoneal carcinomatosis.
The authors retrospectively assessed 20 patients with EOC and pathologically diagnosed as NLNM between January 2001 and December 2010. The patients were divided into two groups according to the time of NLNM identification. Statistical methods included Kaplan-Meier, log-rank, and Cox regression analysis.
Eleven patients were diagnosed with NLNM at the same time of surgical exploration of EOC (Group A) and nine patients at cancer recurrence 43.3 months after initial surgery (Group B). In Group A, patients with tumors confined to the pelvic cavity had no recurrence or had isolated lymph node recurrence (ILNR), and survived longer than patients with abdominal tumor spreading (P = 0.0007). In Group B, 2 patients showed ILNR. The median survival time after NLNM was 42 months in Group A and 6 months in Group B (P = 0.01). Cox model demonstrated that non-serous histology, brain metastasis, and NLNM identified at cancer recurrence were major predictors for poor overall survival (Hazard ratio [HR] = 18.67, 6.93, and 4.52; P = 0.01, 0.02, and 0.04, respectively).
A subgroup of EOC patients with NLNM who presented limited pelvic cancer had much better overall survival than patients who had cancer spreading beyond the pelvic cavity or were diagnosed with NLNM at cancer recurrence.
上皮性卵巢癌（EOC）的颈部淋巴结转移（NLNM）较为罕见，且被视为晚期癌症进行治疗。然而，有淋巴转移的卵巢癌可能与腹膜种植转移表现出不同的临床病程。
作者回顾性评估了 2001 年 1 月至 2010 年 12 月期间经病理诊断为 NLNM 的 20 例 EOC 患者。根据 NLNM 确诊时间将患者分为两组。统计学方法包括 Kaplan-Meier、对数秩和 Cox 回归分析。
11 例患者在 EOC 手术探查时同时诊断为 NLNM（A 组），9 例患者在初次手术后 43.3 个月时癌症复发时诊断为 NLNM（B 组）。在 A 组中，肿瘤局限于盆腔的患者无复发或仅出现孤立性淋巴结复发（ILNR），且生存期长于出现腹部肿瘤扩散的患者（P = 0.0007）。在 B 组中，有 2 例患者出现 ILNR。A 组中 NLNM 后的中位生存时间为 42 个月，B 组为 6 个月（P = 0.01）。Cox 模型表明，非浆液性组织学、脑转移和复发时诊断的 NLNM 是总体生存不良的主要预测因素（风险比[HR] = 18.67、6.93 和 4.52；P = 0.01、0.02 和 0.04）。
NLNM 患者中，局限于盆腔的癌症患者总体生存情况明显优于癌症扩散至盆腔以外或在癌症复发时诊断为 NLNM 的患者。
