Wang Jieyu, Chen Ruifang, Li Jun, Lu Xin
Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, No. 128, Shenyang Road, Yangpu District, Shanghai, 200090, China.
Shanghai Key Laboratory of Female Reproductive Endocrine-Related Disease, Fudan University, Shanghai, China.
Arch Gynecol Obstet. 2020 Dec;302(6):1441-1450. doi: 10.1007/s00404-020-05772-3. Epub 2020 Sep 4.
To evaluate the therapeutic role of lymphadenectomy on patients with malignant ovarian germ cell tumor (MOGCT) and to investigate the risk factors of lymph node metastasis.
Patients of MOGCT between 1988 and 2013 with definite lymph node information were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Survival curves were estimated using the Kaplan-Meier method, and Cox regression analyses were performed to evaluate the effects of clinical and pathologic variables on survival.
2424 MOGCT patients with information on lymph nodes were included. Of the entire cohort, 46.2% patients received lymphadenectomy. The most common (42.2%) histologic type was teratoma, and 70.6% patients had FIGO stage I disease. Cox proportional model verified that age, grade, and log odds of positive lymph nodes (LODDS) were independent prognostic factors. Subgroup analysis showed that the association between the lymph node resection and better survival in the different age cohort.
Lymphadenectomy is not recommended for children (0-14 years). For patients 40 years of age and older, and for those who have the dysgerminoma type or endodermal sinus type, lymphadenectomy had an outstanding therapeutic role. As a parameter to assess lymph node status, LODDS could be used to classify MOGCTs.
评估淋巴结切除术对恶性卵巢生殖细胞肿瘤（MOGCT）患者的治疗作用，并探讨淋巴结转移的危险因素。
从监测、流行病学和最终结果（SEER）数据库中提取1988年至2013年有明确淋巴结信息的MOGCT患者。采用Kaplan-Meier法估计生存曲线，并进行Cox回归分析以评估临床和病理变量对生存的影响。
纳入2424例有淋巴结信息的MOGCT患者。在整个队列中，46.2%的患者接受了淋巴结切除术。最常见的组织学类型是畸胎瘤（42.2%），70.6%的患者为国际妇产科联盟（FIGO）I期疾病。Cox比例模型证实年龄、分级和淋巴结阳性对数比（LODDS）是独立的预后因素。亚组分析显示不同年龄队列中淋巴结切除与更好生存之间的关联。
不建议对儿童（0 - 14岁）进行淋巴结切除术。对于40岁及以上的患者，以及患有无性细胞瘤或内胚窦瘤类型的患者，淋巴结切除术具有显著的治疗作用。作为评估淋巴结状态的参数，LODDS可用于MOGCT的分类。
