Inoue T, Chihara T, Morita K
Gynecol Oncol. 1986 Oct;25(2):234-43. doi: 10.1016/0090-8258(86)90104-6.
Radical hysterectomy with pelvic and common iliac lymphadenectomy was done for 207 Stage IB (148), IIA (19), and IIB (40) cervical carcinomas. Pelvic nodal involvement was limited in 30 (14.5%) cases, whereas common iliac nodes were involved in 16 (7.7%) cases. Common iliac node metastases were significantly increased, when the number of positive pelvic nodes increased from 2 to 3 or 4 or more (21.4% to 73.3%, P less than 0.05), when the tumor invaded deeper than 20 mm (3.7% to 22.2%, P less than 0.001), and when the tumor extended into parametrial tissues (4.8% to 14.8%, P less than 0.05). Postoperative extended-field irradiation was administered to 40 patients with nodal metastases. The 3-year disease-free rates were 85% in 24 patients with positive pelvic nodes, and 51% in 16 patients with common iliac node metastases; 70% in total. These results indicate that postoperative extended-field irradiation is essential for those patients with nodal metastases from locally resectable cervical carcinomas.
对207例IB期（148例）、IIA期（19例）和IIB期（40例）宫颈癌患者实施了根治性子宫切除术及盆腔和髂总淋巴结清扫术。30例（14.5%）患者盆腔淋巴结受累，16例（7.7%）患者髂总淋巴结受累。当盆腔阳性淋巴结数量从2个增加到3个、4个或更多时（从21.4%增至73.3%，P<0.05），当肿瘤浸润深度超过20mm时（从3.7%增至22.2%，P<0.001），以及当肿瘤延伸至宫旁组织时（从4.8%增至14.8%，P<0.05），髂总淋巴结转移显著增加。对40例有淋巴结转移的患者进行了术后扩大野照射。24例盆腔淋巴结阳性患者的3年无病生存率为85%，16例髂总淋巴结转移患者的3年无病生存率为51%；总体为70%。这些结果表明，术后扩大野照射对于那些局部可切除宫颈癌伴有淋巴结转移的患者至关重要。
