Takeshima N, Hirai Y, Yano K, Tanaka N, Yamauchi K, Hasumi K
Department of Gynecology, Cancer Institute Hospital, 1-37-1, Kami-Ikebukuro, Toshima-Ku, Tokyo, 170, Japan.
Gynecol Oncol. 1998 Aug;70(2):183-7. doi: 10.1006/gyno.1998.5086.
A retrospective study was conducted to investigate the clinical significance of ovarian metastasis in 439 patients with clinical stage I endometrial cancer surgically treated by performing total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Histologic examination revealed that 22 patients (5%) had ovarian metastasis. The maximum diameter of the ovarian metastases ranged from 1 to 100 mm. In 18.2% (4/22) of patients with ovarian metastasis, the maximum diameter was less than 2 mm. Patients with metastasis limited to the ovarian surface showed 100% positive peritoneal cytology, 0% lymph node metastases, and 50% recurrence, while patients with metastasis inside the ovary showed 10% positive peritoneal cytology, 36% lymph node metastases, and 53% recurrence. The prognosis of patients with ovarian metastasis alone was situated midway between that of patients with cancer limited to the uterus and that of patients with lymph node metastasis alone. The lymph node status was of importance to determine the prognosis of patients with ovarian metastasis. The series also suggests that there may be two routes for ovarian metastasis; one is a route via the fallopian tube to the ovarian surface and the other is a route via the lymphatics to the inside of the ovary.
进行了一项回顾性研究，以调查439例临床I期子宫内膜癌患者接受全腹子宫切除术、双侧输卵管卵巢切除术和盆腔淋巴结清扫术手术治疗后卵巢转移的临床意义。组织学检查显示，22例患者（5%）发生了卵巢转移。卵巢转移灶的最大直径为1至100毫米。在18.2%（4/22）的卵巢转移患者中，最大直径小于2毫米。转移局限于卵巢表面的患者腹膜细胞学检查100%阳性，淋巴结转移率为0%，复发率为50%；而转移至卵巢内部的患者腹膜细胞学检查阳性率为10%，淋巴结转移率为36%，复发率为53%。单纯卵巢转移患者的预后介于癌症局限于子宫的患者和单纯淋巴结转移的患者之间。淋巴结状态对于确定卵巢转移患者的预后很重要。该系列研究还表明，卵巢转移可能有两条途径；一条是通过输卵管至卵巢表面的途径，另一条是通过淋巴管至卵巢内部的途径。
