吴小华 张志毅 唐美琴 陈洁 200032 上海医科大学肿瘤医院妇科 中华肿瘤杂志 1999 0 21 4


    关键词：卵巢肿瘤/外科学；淋巴结切除术；二次探查术 期刊 zhzlzz 0 临床应用 fur -->


    

【摘要 】 目的 回顾性分析卵巢癌二探术中施行腹膜后淋巴结广泛切除的疗效。方法 在二探术过程中均行系统的腹膜后淋巴结切除术，包括左肾静脉下缘水平的腹主动脉旁淋巴结和盆腔各组淋巴结，回顾性分析行二探术阳性发现结果和患者的预后。结果 接受二探术治疗的63例患者中，24例(38.1%)发现有肿瘤残存，二探术阳性率与临床期别、首次细胞减灭术后残留灶大小正相关，而与组织分化程度无关。在淋巴结转移(lymphnode metastasis, LNM)的19例(30.2%)中，仅有8例无盆腹腔残留肿瘤。39例二探术阴性患者中，4例(10.3%)复发。全部患者的3年和5年生存率分别为75.4%和68.3%。结论 在二探术中行淋巴结切除术扩大了探查范围，可减低卵巢癌患者阴性二探术后的复发率。

Therapeutic results of second-looklaporatomy with extensive dissection of retroperitoneal lymph nodes in ovarian cancerpatients

WU Xiaohua, ZHANG Zhiyi, TANG Meiqin, et al. Cancer Hospital, Shanghai Medical University, Shanghai 200032

【Abstract】 Objective Toevaluate retrospectively the results of extensive lymphadenectomy during second-looklaparotomy in patients with ovarian cancer.Methods A total of 63patients with ovarian malignancies received second-look laparotomy (SLL). Retroperitoneallymph nodes, including para-aortic nodes below the level of left renal vein and pelvicnodes were extensively dissected.Results Of the 63 patients, residualtumor was found in 24 (38.1%) on SLL. The frequency of residual tumor was positivelycorrelated with the clinical stage and with the amount of tumor left after initialdebulking but not with degree of differentiation of tumor cells. Lymph node metastasis waspathologically confirmed in 19 cases (30.2%), in which no residual tumor was found in 8patients. Tumor recurred in only 4 of the 39 patients (10.3%) with negative SLL. Theoverall 3- and 5-year survival rate was 75.4% and 68.3%, respectively.Conclusion Extensiveretroperitoneal lymph node dissection is recommended during SLL. It favors a decrease inrecurrence rate in ovarian cancer patients negative on SLL.

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