Li Xianxian, Xing Hui, Li Lin, Huang Yanli, Zhou Min, Liu Qiong, Qin Xiaomin, He Min
Department of Obstetrics and Gynecology, Xiangyang Central Hospital, Hospital Affiliated to Hubei University of Arts and Science, Xiangyang, 441021, China.
Front Med. 2014 Mar;8(1):96-100. doi: 10.1007/s11684-014-0316-4. Epub 2014 Jan 25.
Lymph node metastasis has an important effect on prognosis of patients with ovarian cancer. Moreover, the impact of para-aortic lymph node (PAN) removal on patient prognosis is still unclear. In this study, 80 patients were divided into groups A and B. Group A consisted of 30 patients who underwent PAN + pelvic lymph node (PLN) dissection, whereas group B consisted of 50 patients who only underwent PLN dissection. Analysis of the correlation between PAN clearance and prognosis in epithelial ovarian cancer was conducted. Nineteen cases of lymph node metastasis were found in group A, among whom seven cases were positive for PAN, three cases for PLN, and nine cases for both PAN and PLN. In group B, 13 cases were positive for lymph node metastasis. Our study suggested that the metastatic rate of lymph node is 40.0%. Lymph node metastasis was significantly correlated with FIGO stage, tumor differentiation, and histological type both in groups A and B (P < 0.05). In groups A and B, the three-year survival rates were 77.9% and 69.0%, and the five-year survival rates were 46.7% and 39.2%, respectively. However, the difference was not statistically significant (P > 0.05). The three-year survival rates of PLN metastasis in groups A and B were 68.5% and 41.4%, and the five-year survival rates were 49.7% and 26.4%, respectively. Furthermore, PLN-positive patients who cleared PAN had significantly higher survival rate (P = 0.044). In group A, the three-year survival rates of positive and negative lymph nodes were 43.5% and 72.7%, and the five-year survival rates were 27.2% and 58.5%, respectively. The difference was statistically significant (P = 0.048). Cox model analysis of single factor suggested that lymph node status affected the survival rate (P < 0.01), which was the death risk factor. Consequently, in ovarian carcinoma cytoreductive surgery, resection of the para-aortic lymph node, which has an important function in clinical treatment and prognosis of patients with ovarian cancer, is necessary.
淋巴结转移对卵巢癌患者的预后有重要影响。此外，腹主动脉旁淋巴结（PAN）清扫对患者预后的影响仍不明确。本研究将80例患者分为A组和B组。A组由30例行PAN + 盆腔淋巴结（PLN）清扫的患者组成，而B组由50例仅行PLN清扫的患者组成。对上皮性卵巢癌中PAN清除与预后的相关性进行了分析。A组发现19例淋巴结转移，其中7例PAN阳性，3例PLN阳性，9例PAN和PLN均阳性。B组有13例淋巴结转移阳性。我们的研究表明淋巴结转移率为40.0%。A组和B组中，淋巴结转移均与国际妇产科联盟（FIGO）分期、肿瘤分化及组织学类型显著相关（P < 0.05）。A组和B组的三年生存率分别为77.9%和69.0%，五年生存率分别为46.7%和39.2%。然而，差异无统计学意义（P > 0.05）。A组和B组中PLN转移的三年生存率分别为68.5%和41.4%，五年生存率分别为49.7%和26.4%。此外，清除PAN的PLN阳性患者生存率显著更高（P = 0.044）。在A组中，阳性和阴性淋巴结的三年生存率分别为43.5%和72.7%，五年生存率分别为27.2%和58.5%。差异有统计学意义（P = 0.048）。单因素Cox模型分析表明淋巴结状态影响生存率（P < 0.01），是死亡危险因素。因此，在卵巢癌肿瘤细胞减灭术中，切除腹主动脉旁淋巴结对卵巢癌患者的临床治疗和预后具有重要作用，是必要的。
