Department of Gynecologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
J Gynecol Oncol. 2021 May;32(3):e40. doi: 10.3802/jgo.2021.32.e40.
To estimate the impact of lymph node dissection on survival in patients with apparent early-stage epithelial ovarian cancer (EOC).
We conducted a retrospective review of patients with clinical stage I-II EOC. All patients underwent primary surgery at Sun Yat-sen University Cancer Center between January 2003 and December 2015. Demographic features and clinicopathological information as well as perioperative adverse events were investigated, and survival analyses were performed.
A total of 400 ovarian cancer patients were enrolled, and patients were divided into 2 groups: 81 patients did not undergo lymph node resection (group A), and 319 patients underwent lymph node dissection (group B). In group B, the median number of removed nodes per patient was 25 (21 pelvic and 4 para-aortic nodes). In groups A and B, respectively, the 5-year progression-free survival (PFS) rates were 83.3% and 82.1% (p=0.305), and the 5-year overall survival (OS) rates were 93.1% and 90.9% (p=0.645). The recurrence rate in the retroperitoneal lymph nodes was not associated with lymph node dissection (p=0.121). The median operating time was markedly longer in group B than in group A (220 minutes vs. 155 minutes, p<0.001), and group B had a significantly higher incidence of lymph cysts at discharge (32.9% vs. 0.0%, p<0.001).
In patients with early-stage ovarian cancer, lymph node dissection was not associated with a gain in OS or PFS and was associated with an increased incidence of perioperative adverse events.
评估淋巴结清扫术对临床早期上皮性卵巢癌（EOC）患者生存的影响。
我们对中山大学肿瘤防治中心 2003 年 1 月至 2015 年 12 月期间接受初次手术治疗的临床 I 期-II 期 EOC 患者进行了回顾性分析。调查了患者的人口统计学特征和临床病理资料以及围手术期不良事件，并进行了生存分析。
共纳入 400 例卵巢癌患者，分为两组：81 例未行淋巴结切除术（A 组），319 例行淋巴结清扫术（B 组）。B 组患者每例平均切除淋巴结 25 个（21 个盆腔淋巴结和 4 个腹主动脉旁淋巴结）。A、B 组 5 年无进展生存率（PFS）分别为 83.3%和 82.1%（p=0.305），5 年总生存率（OS）分别为 93.1%和 90.9%（p=0.645）。腹膜后淋巴结复发率与淋巴结清扫术无关（p=0.121）。B 组手术时间明显长于 A 组（220 分钟比 155 分钟，p<0.001），B 组术后淋巴囊肿的发生率明显高于 A 组（32.9%比 0.0%，p<0.001）。
在早期卵巢癌患者中，淋巴结清扫术并未带来生存获益，反而增加了围手术期不良事件的发生率。
