Department of Gynaecological Oncology, Centre for Gynaecological Oncology Amsterdam, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Division of Diagnostic Oncology & Molecular Pathology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
BJOG. 2017 Feb;124(3):486-494. doi: 10.1111/1471-0528.14425. Epub 2016 Nov 16.
The use of lymph node sampling during staging procedures in clinical early-stage mucinous ovarian carcinoma (MOC) is an ongoing matter of debate. Furthermore, the incidence of lymph node metastases (LNM) in MOC in relation to tumour grade (G) is unknown. We aimed to determine the incidence of LNM in clinical early-stage MOC per tumour grade.
Retrospective study with data from the Dutch Pathology Registry (PALGA).
The Netherlands, 2002-2012.
Patients with MOC.
Histology reports on patients with MOC diagnosed in the Netherlands between 2002 and 2012 were obtained from PALGA. Reports were reviewed for diagnosis, tumour grade and presence of LNM. Clinical data, surgery reports and radiology reports of patients with LNM were retrieved from hospital files.
Incidence of LNM, disease-free survival (DFS).
Of 915 patients with MOC, 426 underwent lymph node sampling. Cytoreductive surgery was performed in 267 patients. The other 222 patients received staging without lymph node sampling. In eight of 426 patients, LNM were discovered by sampling. In four of 190 (2.1%) patients with G1 MOC, LNM were present, compared with one of 115 (0.9%) patients with G2 MOC and three of 22 (13.6%) patients with G3 MOC. Tumour grade was not specified in 99 patients. Patients with clinical early-stage MOC had no DFS benefit from lymph node sampling.
LNM are rare in early-stage G1 and G2 MOC without clinical suspicion of LNM. Therefore, lymph node sampling can be omitted in these patients.
Lymph node sampling can be omitted in clinical early-stage G1 and G2 mucinous ovarian cancer.
在临床早期黏液性卵巢癌（MOC）分期手术中使用淋巴结取样是一个持续存在的争议问题。此外，MOC 中肿瘤分级（G）与淋巴结转移（LNM）的发生率尚不清楚。我们旨在确定按肿瘤分级（G）划分的临床早期 MOC 中 LNM 的发生率。
来自荷兰病理学登记处（PALGA）的回顾性研究数据。
荷兰，2002-2012 年。
患有 MOC 的患者。
从 PALGA 获取荷兰 2002 年至 2012 年间诊断为 MOC 的患者的组织学报告。对报告进行了诊断、肿瘤分级和 LNM 存在的审查。从医院档案中检索了患有 LNM 的患者的临床数据、手术报告和放射学报告。
LNM 的发生率、无病生存率（DFS）。
在 915 名患有 MOC 的患者中，有 426 名患者进行了淋巴结取样。267 名患者进行了减瘤性手术。其余 222 名患者进行了不进行淋巴结取样的分期。在 426 名患者中有 8 名发现 LNM 取样。在 190 名 G1 MOC 患者中有 4 名（2.1%）存在 LNM，而在 115 名 G2 MOC 患者中有 1 名（0.9%），在 22 名 G3 MOC 患者中有 3 名（13.6%）。99 名患者未指定肿瘤分级。患有临床早期 MOC 的患者未从淋巴结取样中获得无疾病生存获益。
在无 LNM 临床可疑的早期 G1 和 G2 MOC 中，LNM 罕见。因此，可以在这些患者中省略淋巴结取样。
在临床早期 G1 和 G2 黏液性卵巢癌中，可以省略淋巴结取样。
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