晚期上皮性卵巢癌孤立性颈部淋巴结转移化疗的临床疗效分析

Clinical efficacy analysis of chemotherapy of isolated neck lymphatic metastasis in advanced epithelial ovarian cancer.

作者信息

Liu Hong, Luo Min, Peng Chunrong, Cheng Xinghan, Wang Dengfeng, Huang Jianming, Zhang Guonan

机构信息

Present Address: Gynecologic Oncology Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, South People' Road, Chengdu, 610041, China.

Department of Oncology, The Sixth People's Hospital of Chengdu, Chengdu, China.

出版信息

BMC Cancer. 2025 May 30;25(1):969. doi: 10.1186/s12885-025-14399-z.

DOI:10.1186/s12885-025-14399-z

PMID:40448079

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12123708/

Abstract

OBJECTIVE

The aim of this study was to retrospectively investigate the efficacy of chemotherapy for neck lymph node metastasis (NLNM) by determining the characteristics and survival of patients with isolated NLNMs metastases from epithelial ovarian carcinoma (EOC) at stage IV of the Federation of Gynecology and Obstetrics (FIGO).

METHODS

The clinicopathological characteristics and survival outcome of 24 cases with stage IV FIGO EOC with isolated NLNM were retrospectively analyzed between December 1, 2014, and November 30, 2021.

RESULTS

Among the 24 patients, 2 (8.3%) underwent primary debulking surgery (PDS), 21 (87.5%) received neoadjuvant chemotherapy(NACT) followed by interval debulking surgery (IDS), and 1 (4.2%) received chemotherapy alone. Additionally, 13 (54.2%) cases achieved abdominal R0 debulking, while 11(45.8%) cases achieved R1/R2 debulking. The chemotherapy response of NLNMs included complete response (8/24, 33.3%), partial response (15/24,62.5%), or stable disease (1/24,41.7%). None of the patients received resection or radiotherapy of NLNMs. Recurrence was observed in 15 (62.5%) patients, with only 2 experiencing recurrence of NLNMs. The median progression-free survival (PFS) and overall survival (OS) were 35 months and 48 months, respectively. R0 debulking led to a significantly longer PFS (not reached) and OS (57 months) compared to non-R0 debulking (PFS: 10 months, P = 0.001; OS: 22 months, P = 0.001). Interestingly, patients with EOC with lymphatic recurrence had better OS ( 57 months) than did those with abdominal or distant recurrence (OS: 29 months; P = 0.012).

CONCLUSIONS

Chemotherapy is an effective treatment for neck lymph nodes metastasis, and a favorable response to chemotherapy could eliminate the necessity for NLNM resection or radiotherapy. Effective control of abdominal disease with surgery may be a critical factor in managing FIGO stage IV EOC patients with isolated NLMNs.

摘要

目的

本研究旨在通过确定国际妇产科联盟（FIGO）IV期上皮性卵巢癌（EOC）孤立性颈部淋巴结转移（NLNM）患者的特征和生存率，回顾性研究化疗对颈部淋巴结转移的疗效。

方法

回顾性分析2014年12月1日至2021年11月30日期间24例FIGO IV期EOC伴孤立性NLNM患者的临床病理特征和生存结果。

结果

24例患者中，2例（8.3%）接受了初次肿瘤细胞减灭术（PDS），21例（87.5%）接受了新辅助化疗（NACT），随后进行间隔肿瘤细胞减灭术（IDS），1例（4.2%）仅接受化疗。此外，13例（54.2%）患者实现了腹部R0肿瘤细胞减灭，而11例（45.8%）患者实现了R1/R2肿瘤细胞减灭。NLNMs的化疗反应包括完全缓解（8/24，33.3%）、部分缓解（15/24，62.5%）或病情稳定（1/24，41.7%）。所有患者均未接受NLNMs的切除或放疗。15例（62.5%）患者出现复发，其中仅2例出现NLNMs复发。中位无进展生存期（PFS）和总生存期（OS）分别为35个月和48个月。与非R0肿瘤细胞减灭相比，R0肿瘤细胞减灭导致PFS（未达到）和OS（57个月）显著延长（PFS：10个月，P = 0.001；OS：22个月，P = 0.001）。有趣的是，EOC伴淋巴转移复发的患者OS（57个月）优于腹部或远处转移复发的患者（OS：29个月；P = 0.012）。