Klein M, Rosen A, Lahousen M, Graf A, Vavra N, Beck A
Department of Gynecology, Hanusch-Hospital, Vienna, Austria.
Arch Gynecol Obstet. 1993;253(1):21-5. doi: 10.1007/BF02770629.
The primary carcinoma of the Fallopian tube is a highly aggressive tumor which can spread by the lymphatic route. The object of the present study was to evaluate the impact of radical pelvic and para-aortic lymphadenectomy on overall survival. Radical lymphadenectomy was performed on twelve patients in addition to hysterectomy and bilateral adnexectomy (group I). Twenty-eight patients subjected only to hysterectomy and adnexectomy formed the control group (group II). On average 47.6 lymph nodes were excised per patient. As long as the carcinoma was limited to adnexa and uterus (stages I and II), no lymph node metastases were found, only in stages III and IV were lymph node metastases detectable. Even though the median survival time of group I was considerably higher than of group II (43 versus 35 months), there was no statistically significant difference between the two groups (P < 0.65). Patients with stage III and stage IV disease had relatively longer median survival times if they had a lymphadenectomy. However, the difference was not statistically significant (P < 0.91). We cannot therefore recommend routine radical lymphadenectomy for primary Fallopian tube carcinoma. Whether or not lymph node dissection would lead to better results from rational selection of patient for adjuvant therapy is not known.
原发性输卵管癌是一种侵袭性很强的肿瘤，可通过淋巴途径扩散。本研究的目的是评估根治性盆腔和腹主动脉旁淋巴结清扫术对总生存期的影响。除子宫切除术和双侧附件切除术外，对12例患者进行了根治性淋巴结清扫术（第一组）。仅接受子宫切除术和附件切除术的28例患者组成对照组（第二组）。每位患者平均切除47.6个淋巴结。只要癌症局限于附件和子宫（I期和II期），就未发现淋巴结转移，仅在III期和IV期可检测到淋巴结转移。尽管第一组的中位生存时间明显高于第二组（43个月对35个月），但两组之间无统计学显著差异（P<0.65）。III期和IV期疾病的患者如果接受了淋巴结清扫术，其中位生存时间相对较长。然而，差异无统计学意义（P<0.91）。因此，我们不建议对原发性输卵管癌进行常规根治性淋巴结清扫术。淋巴结清扫术是否会通过合理选择辅助治疗患者而带来更好的结果尚不清楚。
