Li He, Dong Yangyang, Dai Yibo, Wang Zhiqi, Wang Jianliu
Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
Transl Cancer Res. 2022 Jul;11(7):2217-2224. doi: 10.21037/tcr-21-2588.
The lymph node (LN) is one of the main sites of recurrence in patients with endometrial carcinoma (EC). Literature specifically analyzing LN recurrence (LNR) in EC remains limited in number.
Patients with EC undergoing surgery between 2006 and 2021 in Peking University People's Hospital was included, clinicopathological data of whom were collected and analyzed retrospectively by R 4.0.3.
A total of 792 patients were included, with 73 patients having recurrence, among whom 21 patients had LNR. Median recurrence-free survival (RFS) in patients with LNR was 16 [4-39] months. LNR was extensive, with pelvic LNs most commonly involved (9/21). There are various patterns of LNR, with 33.3% (7/21) LN-only recurrence. Multivariable analysis suggested advanced stage, larger tumor diameter and poor histology were independent risk factors for LNR. Patients with LN metastasis (LNM) diagnosed at initial treatment accounted for 47.6% (10/21) of cases with LNR, 60.0% (6/10) of whom had recurrent LNs beyond the region of LNM, 90.0% (9/10) of whom had recurrence nodes overlapping with the range of lymphadenectomy. Uni- and multi-variable analysis suggested lymphadenectomy was not a protective factor for LNR, with both the range and number of LNs harvested considered.
LNR is common in patients with EC, with an extensive range and various patterns of recurrence. The International Federation of Gynecology and Obstetrics (FIGO) stage, tumor diameter and histology were independent risk factors for LNR, but lymphadenectomy seemed not a protective factor for LNR.
淋巴结（LN）是子宫内膜癌（EC）患者复发的主要部位之一。专门分析EC中LN复发（LNR）的文献数量仍然有限。
纳入2006年至2021年期间在北京大学人民医院接受手术的EC患者，收集其临床病理数据，并通过R 4.0.3进行回顾性分析。
共纳入792例患者，其中73例复发，21例发生LNR。LNR患者的无复发生存期（RFS）中位数为16 [4 - 39]个月。LNR范围广泛，盆腔淋巴结最常受累（9/21）。LNR有多种模式，仅LN复发占33.3%（7/21）。多变量分析表明，晚期、肿瘤直径较大和组织学分级差是LNR的独立危险因素。初始治疗时诊断为LN转移（LNM）且发生LNR的患者占47.6%（10/21），其中60.0%（6/10）的患者复发淋巴结超出LNM区域，90.0%（9/10）的患者复发淋巴结与淋巴结清扫范围重叠。单变量和多变量分析均表明，考虑到清扫的淋巴结范围和数量，淋巴结清扫术不是LNR的保护因素。
LNR在EC患者中很常见，复发范围广泛且模式多样。国际妇产科联盟（FIGO）分期、肿瘤直径和组织学是LNR的独立危险因素，但淋巴结清扫术似乎不是LNR的保护因素。
