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原发性输卵管癌的淋巴结切除术与生存改善相关。

Lymphadenectomy in Primary Fallopian Tube Cancer is Associated with Improved Survival.

机构信息

Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

J Invest Surg. 2022 Jun;35(6):1417-1423. doi: 10.1080/08941939.2022.2048142. Epub 2022 Mar 28.

Abstract

BACKGROUND AND OBJECTIVES

Primary fallopian tube cancer (PFTC) shares the same diagnostic and management guidelines with epithelial ovarian cancer (EOC). The LION trail raised concerns regarding the role of systematic pelvic and para-aortic lymphadenectomy during debulking surgery. We aimed to evaluate the significance of lymphadenectomy in PFTC survival.

METHODS

This retrospective study analyzed the clinical features and survival of patients with PFTC who underwent primary surgery in our center between January 2013 and October 2020.

RESULTS

Sixty-one patients diagnosed with PFTC were included in the study. Twenty-five (41.0%, 25/61) were diagnosed with FIGO (International Federation of Gynecology and Obstetrics) stages I/II and 36 (59.0%, 36/61) were diagnosed with stage III/IV. Twenty-nine (47.5%, 29/61) underwent pelvic lymphadenectomy with or without para-aortic lymphadenectomy, among which 12 (41.4%, 12/29) had lymph node metastasis confirmed by postoperative pathology. The mean progression-free survival was 60.4 months in the lymphadenectomy group and 37.8 months in the no-lymphadenectomy group ( = 0.042, HR 0.374, 95% CI 0.145-0.966).

CONCLUSIONS

PFTC is often diagnosed earlier and has a better prognosis than EOC. Most patients with PFTC would benefit from lymphadenectomy. However, the extent to which this association translates to a more diverse population needs to be further identified.

摘要

背景与目的

原发性输卵管癌(PFTC)与上皮性卵巢癌(EOC)具有相同的诊断和管理指南。LION 试验对在肿瘤细胞减灭术期间进行系统的盆腔和腹主动脉旁淋巴结切除术的作用提出了质疑。我们旨在评估淋巴结切除术在 PFTC 生存中的意义。

方法

本回顾性研究分析了 2013 年 1 月至 2020 年 10 月期间在我们中心接受初次手术治疗的 PFTC 患者的临床特征和生存情况。

结果

本研究纳入了 61 例确诊为 PFTC 的患者。25 例(41.0%,25/61)诊断为 FIGO(国际妇产科联合会)Ⅰ/Ⅱ期,36 例(59.0%,36/61)诊断为Ⅲ/Ⅳ期。29 例行盆腔淋巴结切除术加或不加腹主动脉旁淋巴结切除术,其中 12 例(41.4%,12/29)术后病理证实有淋巴结转移。淋巴结切除术组的无进展生存期为 60.4 个月,无淋巴结切除术组为 37.8 个月(=0.042,HR 0.374,95%CI 0.145-0.966)。

结论

PFTC 通常比 EOC 更早诊断,预后更好。大多数 PFTC 患者受益于淋巴结切除术。然而,这种关联在更广泛的人群中转化为更大获益的程度仍需进一步确定。

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