Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Int J Gynecol Cancer. 2021 Jan;31(1):104-109. doi: 10.1136/ijgc-2020-001817. Epub 2020 Nov 26.
There is evidence to suggest that the rate of lymph node metastases in patients with ovarian mucinous tumors is rare. The objective of this study was to investigate the prevalence of regional lymph node metastases among patients with apparent stage IA and IC mucinous ovarian carcinoma.
A retrospective cohort study was performed and included patients from the National Cancer Database with apparent stage IA and IC mucinous ovarian tumors who underwent surgery between January 1, 2004 and December 31, 2015. Data collected included demographics, surgical procedures, and pathologic characteristics. The primary outcome was the effect of tumor stage, grade, and size on the risk of lymph node metastases. Categorical and continuous variables were compared using the χ and Mann-Whitney U tests, respectively.
A total of 4379 patients were identified: 3088 and 1213 with stage IA and IC disease, respectively, with an additional 78 patients who were stage I Not Otherwise Specified (NOS). Lymphadenectomy was performed in 70.6% of patients with stage IA and 70.3% of patients with stage IC cancers. Stratifying by grade, 68.4%, 71.3%, and 72.8% of patients with grades 1, 2, and 3 tumors underwent a lymphadenectomy, respectively. Furthermore, lymphadenectomy was performed in 64.9% of patients with tumors <10 cm and 72.4% with tumors >10 cm. Lymph node metastases were identified in 1.2% and 1.6% of patients with stage IA and IC disease, respectively (p=0.063). Additionally, metastases were present in 0.6% of patients with grade 1 tumors, 1.1% of patients with grade 2 tumors, and 5.3% of patients with grade 3 tumors (p<0.001). Lastly, 0.9% of patients with tumors <10 cm and 1.4% of patients with tumors >10 cm had lymph node metastases (p=0.19).
Among patients with mucinous ovarian carcinoma, lymph node metastases are rare. However, metastases are significantly more common in patients with higher grade tumors. These factors may be considered when making decisions regarding the need for lymphadenectomy in early-stage mucinous ovarian tumors.
有证据表明，卵巢黏液性肿瘤患者的淋巴结转移率较低。本研究的目的是探讨在临床分期为 IA 期和 IC 期的卵巢黏液性癌患者中，区域性淋巴结转移的发生率。
本研究为回顾性队列研究，纳入了 2004 年 1 月 1 日至 2015 年 12 月 31 日期间在国家癌症数据库中接受手术治疗的临床分期为 IA 期和 IC 期的卵巢黏液性肿瘤患者。收集的数据包括人口统计学、手术程序和病理特征。主要结局是肿瘤分期、分级和大小对淋巴结转移风险的影响。分类变量和连续变量分别采用 χ 2 和曼-惠特尼 U 检验进行比较。
共纳入 4379 例患者：3088 例为 IA 期，1213 例为 IC 期，另有 78 例为 IA 期未特指（NOS）。70.6%的 IA 期患者和 70.3%的 IC 期患者接受了淋巴结切除术。按分级分层，1 级、2 级和 3 级肿瘤患者中分别有 68.4%、71.3%和 72.8%接受了淋巴结切除术。此外，肿瘤<10cm 的患者中 64.9%接受了淋巴结切除术，肿瘤>10cm 的患者中 72.4%接受了淋巴结切除术。IA 期和 IC 期患者的淋巴结转移率分别为 1.2%和 1.6%（p=0.063）。此外，1 级肿瘤患者中有 0.6%、2 级肿瘤患者中有 1.1%和 3 级肿瘤患者中有 5.3%发生了转移（p<0.001）。最后，肿瘤<10cm 的患者中 0.9%和肿瘤>10cm 的患者中 1.4%发生了淋巴结转移（p=0.19）。
在卵巢黏液性癌患者中，淋巴结转移罕见。然而，转移在高级别肿瘤患者中更为常见。在决定早期卵巢黏液性肿瘤是否需要淋巴结切除术时，可考虑这些因素。
