Department of Obstetrics and Gynecology, Toho University Faculty of Medicine, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan.
World J Surg Oncol. 2020 Apr 1;18(1):64. doi: 10.1186/s12957-020-01841-8.
In patients with epithelial ovarian cancer, whether metastasis to para-aortic lymph nodes located cephalad to the renal veins (supra-renal PAN) should be classified as regional lymph node metastasis or distant metastasis remains controversial. This study was a preliminary retrospective evaluation of the pattern of supra-renal PAN metastasis in patients with epithelial ovarian cancer.
The subjects were 25 patients with epithelial ovarian cancer, primary peritoneal cancer, or fallopian tube cancer who underwent systematic dissection of the para-aortic nodes, including the supra-renal PAN, and pelvic lymph nodes (PLN). Patient factors, perioperative factors, the number of dissected lymph nodes, and pathological lymph node metastasis were investigated.
Supra-renal PAN metastasis was found in 4/25 patients (16.0%). None of the 14 patients with pT1 or pT2 disease had supra-renal PAN metastasis, while 4/11 patients (36.4%) with pT3 or ypT3 disease had such metastases. None of the patients had isolated supra-renal PAN metastasis, while patients with supra-renal PAN metastasis also had multiple metastases to the infra-renal PAN and PLN.
In patients with epithelial ovarian cancer, supra-renal PAN metastases might be considered to be distant rather than regional metastases. Further studies are needed to better define the clinical significance of supra-renal PAN metastasis.
在患有上皮性卵巢癌的患者中，位于肾静脉上方的腹主动脉旁淋巴结（肾上 PAN）转移应归类为区域淋巴结转移还是远处转移仍存在争议。本研究初步回顾性评估了上皮性卵巢癌患者肾上 PAN 转移的模式。
本研究的对象为 25 名患有上皮性卵巢癌、原发性腹膜癌或输卵管癌的患者，他们接受了包括肾上 PAN 和盆腔淋巴结（PLN）在内的腹主动脉旁淋巴结的系统解剖。研究调查了患者因素、围手术期因素、解剖的淋巴结数量以及病理淋巴结转移情况。
4/25 名患者（16.0%）存在肾上 PAN 转移。14 名 pT1 或 pT2 疾病患者无一例存在肾上 PAN 转移，而 11 名 pT3 或 ypT3 疾病患者中有 4 例存在转移。没有患者存在孤立的肾上 PAN 转移，而存在肾上 PAN 转移的患者也存在肾上和肾下 PAN 以及 PLN 的多发转移。
在上皮性卵巢癌患者中，肾上 PAN 转移可能被认为是远处转移而非区域转移。需要进一步的研究来更好地定义肾上 PAN 转移的临床意义。
