Flanagan C W, Mannel R S, Walker J L, Johnson G A
University of Oklahoma College of Medicine, Department of Obstretics and Gynecology, Oklahoma City, USA.
J Am Coll Surg. 1995 Jul;181(1):72-4.
We sought to determine the location of metastases to para-aortic lymph nodes in patients with gynecologic malignancies.
A retrospective chart review was performed for all cases of endometrial, ovarian, and cervical carcinoma in which right and left para-aortic lymph node dissection was done at our institution from 1985 to 1993. Records were assessed for tumor type as well as for presence and location of metastases to para-aortic lymph nodes.
A total of 315 patients had bilateral para-aortic lymphadenectomy performed at the time of laparotomy as part of staging or therapy for their gynecologic malignancies. A total of 47 patients (15 percent) had metastasis to the para-aortic lymph nodes. Para-aortic metastasis were identified in 22 (30 percent) of 73 patients with ovarian carcinoma, 11 (8 percent) of 141 patients with cervical carcinoma, and 14 (14 percent) of 101 patients sampled. Unilateral left-sided para-aortic node involvement was observed in 13 patients, unilateral right-sided involvement was present in 14 patients, and bilateral involvement occurred in 20 patients. Regarding tumor type or origin, no significant difference was noted in right-sided compared with left-sided para-aortic metastases.
Our data suggest no difference in the incidence of metastases to right-sided compared with left para-aortic lymph nodes in patients with gynecologic malignancies, emphasizing the need for bilateral evaluation of the para-aortic lymph nodes. This information is important in the clinical staging of gynecologic malignancies and in establishing protocols requiring para-aortic lymph node dissection.
我们试图确定妇科恶性肿瘤患者腹主动脉旁淋巴结转移的位置。
对1985年至1993年在我院进行左右腹主动脉旁淋巴结清扫术的所有子宫内膜癌、卵巢癌和宫颈癌病例进行回顾性病历审查。评估记录中的肿瘤类型以及腹主动脉旁淋巴结转移的存在情况和位置。
共有315例患者在剖腹手术时进行了双侧腹主动脉旁淋巴结切除术，作为其妇科恶性肿瘤分期或治疗的一部分。共有47例患者（15%）发生腹主动脉旁淋巴结转移。在73例卵巢癌患者中有22例（30%）发现腹主动脉旁转移，141例宫颈癌患者中有11例（8%），101例抽样患者中有14例（14%）。观察到13例患者单侧左侧腹主动脉旁淋巴结受累，14例患者单侧右侧受累，20例患者双侧受累。关于肿瘤类型或起源，右侧与左侧腹主动脉旁转移之间未发现显著差异。
我们的数据表明，妇科恶性肿瘤患者右侧与左侧腹主动脉旁淋巴结转移的发生率没有差异，强调了对腹主动脉旁淋巴结进行双侧评估的必要性。这些信息在妇科恶性肿瘤的临床分期以及制定需要腹主动脉旁淋巴结清扫术的方案方面具有重要意义。
