Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Department of Gynecology, Jinshan Hospital, Fudan University, Shanghai, China.
J Cancer Res Ther. 2024 Aug 1;20(4):1300-1305. doi: 10.4103/jcrt.jcrt_2489_23. Epub 2024 Aug 29.
This study aimed to evaluate the incidence and predict the risk factors of lymph node (LN) metastasis among patients with grossly apparent early-stage epithelial ovarian cancer (EOC).
We retrospectively reviewed the clinicopathologic data and follow-up information of 266 patients who underwent LN dissection for apparent early-stage EOC between January 2018 and September 2022 at the Obstetrics and Gynecology Hospital of Fudan University.
Among 266 patients, 44 (16.5%) showed LN metastasis, of which 65.9% and 59.1% presented in the pelvic region and para-aortic region, respectively. Univariate analysis revealed higher LN positivity in patients with high-grade serous carcinoma (HGSC), preoperative imaging suggestive of LN metastasis, bilateral adnexal involvement, lymphovascular space invasion (LVSI), positive peritoneal cytology, and clinical stage IIA. LN metastases were identified in 7.9%, 10.2%, and 39.7% of clinical stage IA/B, IC, and IIA disease cases, respectively. Multivariate analysis confirmed significantly higher LN positivity rates in patients with HGSC, LVSI, and clinical stage IIA. In clinical stage IIA EOC, the 3-year progression-free survival (PFS) rates were 65.8% and 77.4% (P = 0.360) for LN-negative and LN-positive groups, respectively. In clinical stage I EOC, the 3-year PFS rates were 93.5% and 59.4% (P < 0.001) for LN-negative and LN-positive groups, respectively.
High-grade serous histology, LVSI, and clinical stage IIA disease are predictive factors for LN involvement in early-stage EOC. In addition, LN metastasis appears to be associated with worse PFS in clinical stage I EOC compared with clinical stage IIA EOC.
本研究旨在评估大体早期上皮性卵巢癌（EOC）患者中淋巴结（LN）转移的发生率，并预测其危险因素。
我们回顾性分析了 2018 年 1 月至 2022 年 9 月在复旦大学妇产科医院行 LN 解剖的 266 例明显早期 EOC 患者的临床病理资料和随访信息。
在 266 例患者中，44 例（16.5%）出现 LN 转移，其中 65.9%和 59.1%分别位于盆腔和腹主动脉旁区域。单因素分析显示，高级别浆液性癌（HGSC）、术前影像学提示 LN 转移、双侧附件受累、淋巴血管间隙浸润（LVSI）、阳性腹膜细胞学和临床分期 IIA 的患者 LN 阳性率更高。临床分期 IA/B、IC 和 IIA 疾病患者的 LN 转移率分别为 7.9%、10.2%和 39.7%。多因素分析证实，HGSC、LVSI 和临床分期 IIA 的患者 LN 阳性率显著更高。在临床分期 IIA 的 EOC 中，LN 阴性和 LN 阳性组的 3 年无进展生存率（PFS）分别为 65.8%和 77.4%（P=0.360）。在临床分期 I 的 EOC 中，LN 阴性和 LN 阳性组的 3 年 PFS 率分别为 93.5%和 59.4%（P<0.001）。
高级别浆液性组织学、LVSI 和临床分期 IIA 疾病是早期 EOC 中 LN 受累的预测因素。此外，与临床分期 IIA 的 EOC 相比，LN 转移似乎与临床分期 I 的 EOC 患者的 PFS 更差相关。
