腹膜后淋巴结切除术对临床Ⅰ期卵巢上皮癌预后影响.docVIP

腹膜后淋巴结切除术对临床Ⅰ期卵巢上皮癌预后影响 　　doi：10.3969/j.issn.1007-614x.2014.9.29 　　摘 要 目的：探讨腹膜后淋巴结切除术对Ⅰ期卵巢上皮癌预后的影响。方法：收治Ⅰ期卵巢上皮癌患者82例，对其临床资料进行回顾性分析。接受全面严格分期手术的42例为观察组，因各种原因未接受腹膜后淋巴结切除的40例为对照组，比较两组的临床病理资料、预后相关因素。结果：观察组与对照组患者的2年及5年生存率比较差异无统计学意义（P0.05）。分化程度低的卵巢癌患者的淋巴结转移率高。进行COX逐步回归多因素分析显示，对于行分期手术者，淋巴结阴性预后好于淋巴结阳性患者。结论：对于临床Ⅰ期的卵巢上皮癌患者，进行腹膜后淋巴结切除术对精确分期有重要意义，但并不能改善患者的预后。对于第1次手术未实行严格分期手术的患者，是否需要二次分期手术值得商榷。 　　关键词 腹膜后淋巴结切除术 卵巢上皮癌 生存率 预后 　　Prognostic impact of retroperitoneal lymph node dissection to epithelial ovarian cancer in clinical stage I 　　Yang Dongxia，Ma Guixia 　　Obstetrics and Gynecology Department of The first peoples Hospital of Zhengzhou city in Henan Province，450004 　　Abstract Objective：To explore the prognostic impact of retroperitoneal lymph node dissection to epithelial ovarian cancer in clinical stage I.Methods：We selected 82 patients of epithelial ovarian cancer in clinical stage I in 2000 January to 2013 January，the clinical data of these patients were retrospectively analyzed.42 cases accepted the thorough staging operation were in observation group，40 cases without the retroperitoneal lymph node dissection for a variety of reasons were in control group.Related factors of prognosis，clinical and pathological data of the two groups were compared.Results：The difference of 2 years and 5 years survival rate of the two groups was no significant（P0.05）.The low degree of differentiation of ovarian cancer patients had high lymph node metastasis rate.COX regression analysis showed that，in the patients with staging operation，the prognosis of patients with negative lymph nodes was better than that in patients with positive lymph nodes.Conclusion：For clinical stage I epithelial ovarian cancer patients，resection of retroperitoneal lymph nodes is important for accurate staging，but can not improve the prognosis of the patients.For the patients in first time operation without strict staging，whether you need two stage operation according to the actual situation. 　　Key words Retroper