摘要
目的：探讨腹膜后淋巴结清除在晚期卵巢上皮癌治疗中的地位。方法：１９８４年１月至１９９８年１２月综合治疗晚期卵巢上皮性癌１２０例，其中Ⅲ期１０３例，Ⅳ期１７例。病例均行全子宫双附件大网膜（或加阑尾）切除术；另外，３４例清除了盆腔腹膜，９例切除了部分直肠或乙状结肠，５例切除部分小肠，３例切除右半结肠；１２０例中８１例清扫了盆腔和腹主动脉旁淋巴结，其中 ５４例淋巴结癌转移。术后用 ＦＰＭ（５—ＦＵ，ＤＤＰ，ＭＭＣ）化疗方案腹腔和全身化疗。结果：经逐年随访，１２０例中可随访５年以上者９６例，６０例生存，总的５年生存率为６２．５０％。盆腹腔内残留肿瘤＜２ｃｍ淋巴结清扫者５年生存率为７６．１９％（４８／６３），非清扫者为５７．１４％（１２／２１），Ｐ〈０．０５；淋巴结癌转移者清扫后５年生存率７５．００％（３０／４０），淋巴结非转移者为７８．２６％（１８／２３）。结论：腹膜后淋巴结清除对减少淋巴结转移灶的远期复发，远处转移和提高５年以上远期疗效有不可忽视的作用。
Objective To study the role of resection of retroperitoneal lymph nodes in the treatment of late stage ovarian epithelial cancer. Methods: From Jan 1984 to Dec 1998, 120 patients with late stage ovarian epithelial cancer received comprehensive therapy. Among them, stage Ⅲ and stage Ⅳ were 103 cases and 17 cases respectively. All patients received a hysterectomy with oophorosalpingectomy and omentectomy (or appendectomy). Pelvic peritoneum with implanted tumors was dissected in 34 cases, partial rectum and sigmoid colon were resected in 9 cases, partial small intestine was resected in 5 cases and right hemicolectomy was performed in 3 cases. The pelvic retroperitoneal and para aortic lymph nodes were clearly removed in 81 cases, and 54 cases of them had lymph node metastases. All cases received intraabdominal chemotherapy and systemic chemotherapy with FPM (5-Fu, DDP, MMC) regimen. Results: Ninety-six of 120 cases were followed up for more than 5 years. The 5-year survival rate of these patients was 62.50% (60/96). The 5-year survival rate of the patients who received retro peritoneal radical lymph adenectomy was 76.19% (48/63) and it was 57.14% (12/21) in the patients without radical adenectomy (P<0.05). The 5-year survival rate of the patients with lymph node metastases and after radical dissection was 75% (30/40) and it was 78.26% (18/23) in non-metastases group (P〉0.90). Conclusion: Retroperitoneal radical lymph adenectomy plays an important role in diminishing the remote reccurrence, distant metastasis of retroperitoneal lymph node metastasis and improving the 5-year survival rate of the late stage ovarian epthelial cancer patients.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2001年第3期192-195,共4页
Chinese Journal of Clinical Oncology
