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淋巴结清扫术在子宫内膜癌患者外科治疗中的作用(回顾性分析)。

The role of lymph node dissection in the surgical treatment of endometrial cancer patients (retrospective analysis).

机构信息

Research Department of Oncogynecology, National Cancer Institute, 33/43 Lomonosov Str, Kyiv, 03022, Ukraine.

出版信息

J Cancer Res Clin Oncol. 2023 Jan;149(1):63-68. doi: 10.1007/s00432-022-04406-2. Epub 2022 Oct 11.

Abstract

PURPOSE

Endometrial cancer in recent years has taken the lead among cancer processes of the female reproductive system. The feasibility of pelvic and para-aortic lymph node dissection in patients with endometrial cancer has always been a controversial issue. The aim of the presented paper is to evaluate the feasibility of pelvic and para-aortic lymph node dissection in patients with endometrial cancer, depending on the stage of the disease, postoperative complications, and patient survival, depending on the volume of surgical intervention.

METHODS

The study involved 285 patients with stages of I-IV endometrioid endometrial cancer of the Pre-graduate Department of Oncogynecology of the National Cancer Institute. The average age of patients was 55 ± 5.7 years. In 74.5%, the disease was detected at stage I and uterine extirpation was performed with/without appendages.

RESULTS

The duration of the operation varies depending on the volume of intervention-from 1 h 30 min ± 10 min for panhysterectomy, up to 3 h 20 min ± 10 min when performing para-aortic lymph node dissection. The average number of lymph nodes removed was-7 ± 1.1 pelvic and 12 ± 1.5 para-aortic.

CONCLUSION

The basic principles of surgical treatment consist in individual choice of the scope of surgical intervention, performing adequate lymph node dissection, and preventing relapse and metastasis of the disease.

摘要

目的

近年来,子宫内膜癌在女性生殖系统癌症中发病率居首位。在子宫内膜癌患者中进行盆腔和腹主动脉旁淋巴结清扫术的可行性一直是一个有争议的问题。本文旨在评估根据疾病分期、术后并发症和患者生存情况,根据手术干预的范围评估子宫内膜癌患者进行盆腔和腹主动脉旁淋巴结清扫术的可行性。

方法

该研究纳入了国家癌症研究所肿瘤妇科研究生部的 285 名 I-IV 期子宫内膜样子宫内膜癌患者。患者的平均年龄为 55±5.7 岁。74.5%的患者在 I 期发现疾病,并进行了子宫切除术,伴或不伴附件切除。

结果

手术时间取决于干预范围,从全子宫切除术的 1 小时 30 分钟±10 分钟,到腹主动脉旁淋巴结清扫术的 3 小时 20 分钟±10 分钟。切除的淋巴结平均数量为盆腔 7±1.1 个,腹主动脉旁 12±1.5 个。

结论

手术治疗的基本原则包括个体化选择手术干预范围、进行充分的淋巴结清扫,以及预防疾病的复发和转移。

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