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腹膜后淋巴结清扫术在170例卵巢透明细胞癌患者中的治疗作用

Therapeutic Role of Retroperitoneal Lymphadenectomy in 170 Patients With Ovarian Clear Cell Cancer.

作者信息

Gao Wen, Shi Peipei, Sun Haiyan, Xi Meili, Tang Wenbin, Yin Sheng, Zhang Jiarong

机构信息

Department of Gynecologic Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China.

Department of Obstetrics and Gynecology, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

Front Oncol. 2022 Jan 13;11:754149. doi: 10.3389/fonc.2021.754149. eCollection 2021.

Abstract

INTRODUCTION

We evaluated the therapeutic role of retroperitoneal lymphadenectomy in patients with ovarian clear cell cancer (OCCC).

MATERIALS AND METHODS

We retrospectively reviewed 170 OCCC patients diagnosed at two hospitals in China between April 2010 and August 2020. Clinical data were abstracted, and patients were followed until February 2021. Patients were divided into retroperitoneal lymphadenectomy and no lymphadenectomy groups. The Kaplan-Meier method was used to compare progression-free (PFS) and overall survival (OS) between the two groups. Statistical differences were determined by the log-rank test. The COX proportional hazards regression model was applied to identify predictors of tumor recurrence.

RESULTS

The median age was 52 years; 90 (52.9%) and 80 (47.1%) patients were diagnosed as early and advanced stage, respectively. Clinically positive and negative nodes was found in 40 (23.5%) and 119 (70.0%) patients, respectively. Of all the 170 patients, 124 (72.9%) patients underwent retroperitoneal lymphadenectomy, while 46 (27.1%) did not. The estimated 2-year PFS and 5-year OS rates were 71.4% and 65.9% in the lymphadenectomy group, and 72.0% and 73.7% in no lymphadenectomy group (p = 0.566 and 0.669, respectively). There was also no difference in survival between the two groups when subgroup analysis was performed stratified by early and advanced stage, or in patients with clinically negative nodes. Multivariate analysis showed that retroperitoneal lymphadenectomy were not an independent predictor of tumor recurrence.

CONCLUSION

Retroperitoneal lymphadenectomy provided no survival benefit in patients diagnosed with OCCC. A prospective clinical trial is needed to confirm the present results.

摘要

引言

我们评估了腹膜后淋巴结清扫术在卵巢透明细胞癌(OCCC)患者中的治疗作用。

材料与方法

我们回顾性分析了2010年4月至2020年8月在中国两家医院确诊的170例OCCC患者。提取临床数据,并对患者进行随访至2021年2月。患者分为腹膜后淋巴结清扫术组和未行淋巴结清扫术组。采用Kaplan-Meier法比较两组的无进展生存期(PFS)和总生存期(OS)。通过对数秩检验确定统计学差异。应用COX比例风险回归模型识别肿瘤复发的预测因素。

结果

中位年龄为52岁;分别有90例(52.9%)和80例(47.1%)患者被诊断为早期和晚期。分别有40例(23.5%)和119例(70.0%)患者临床淋巴结阳性和阴性。在所有170例患者中,124例(72.9%)患者接受了腹膜后淋巴结清扫术,而46例(27.1%)未接受。淋巴结清扫术组的2年PFS率和5年OS率估计分别为71.4%和65.9%,未行淋巴结清扫术组分别为72.0%和73.7%(p分别为0.566和0.669)。按早期和晚期分层进行亚组分析时,两组生存情况也无差异,临床淋巴结阴性的患者也是如此。多因素分析显示,腹膜后淋巴结清扫术不是肿瘤复发的独立预测因素。

结论

腹膜后淋巴结清扫术对诊断为OCCC的患者无生存获益。需要进行前瞻性临床试验来证实目前的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d128/8791852/05f52499ec9b/fonc-11-754149-g001.jpg

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