文章摘要
陈艳,胡卫平,吴大保,周颖,赵卫东,申震.腹膜后淋巴结清扫术对早期卵巢恶性生殖细胞肿瘤患者生存及预后的影响[J].中国临床保健杂志,2020,23(4):499-504.
腹膜后淋巴结清扫术对早期卵巢恶性生殖细胞肿瘤患者生存及预后的影响
The effect of retroperitoneal lymph node dissection on the survival and prognosis of patients with early ovarian malignant germ cell tumors
投稿时间:2020-04-29  
DOI:10.3969/J.issn.1672-6790.2020.04.016
中文关键词: 肿瘤,生殖细胞和胚胎性  卵巢  淋巴结切除术  预后  存活率
英文关键词: Neoplasms,germ cell and embryonal  Ovary  Lymph node excision  Prognosis  Survival rate
基金项目:安徽省重点研究与开发计划项目(1704a0802151)
作者单位E-mail
陈艳 中国科学技术大学附属第一医院 安徽省立医院 妇产科,合肥 230001 ahslyycy@163.com 
胡卫平 中国科学技术大学附属第一医院 安徽省立医院 妇产科,合肥 230001 ahslyycy@163.com 
吴大保 中国科学技术大学附属第一医院 安徽省立医院 妇产科,合肥 230001 ahslyycy@163.com 
周颖 中国科学技术大学附属第一医院 安徽省立医院 妇产科,合肥 230001 ahslyycy@163.com 
赵卫东 中国科学技术大学附属第一医院 安徽省立医院 妇产科,合肥 230001 ahslyycy@163.com 
申震 中国科学技术大学附属第一医院 安徽省立医院 妇产科,合肥 230001 ahslyycy@163.com 
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中文摘要:
      目的 探讨腹膜后淋巴结清扫术(LND)对早期卵巢恶性生殖细胞肿瘤(MOGCTs)患者生存及预后的影响。方法 通过回顾性分析安徽省立医院2009年11月至2019年7月收治的52例早期MOGCTs患者的临床资料,根据是否行腹膜后淋巴结清扫术分为两组,30例行腹膜后淋巴结清扫患者为LND组,22例未行腹膜后淋巴结清扫患者为Non-LND组,比较两组的生存率及复发率,探讨腹膜后淋巴结清扫术对早期MOGCTs患者生存及预后的影响。结果 30例行LND患者未发现淋巴结转移。术后除8例Ia期无性细胞瘤患者不需化疗外,其余44例患者术后均接受化疗。LND和Non-LND组的复发率(10%与9.09%)比较,差异无统计学意义(P=1.0)。LND组和Non-LND组的5年总生存期(OS) (100%与100%)、5年PFS(90%与95.45%)、10年OS(96.66%与100%)、10年无进展生存期(PFS)(90%与90.90%)差异均无统计学意义(P>0.05)。预后影响因素分析显示:年龄、肿瘤直径、LND及病理类型对预后无明显影响。结论 早期MOGCTs行腹膜后淋巴结清扫对生存及预后无明显影响,早期MOGCTs患者术中可不行LND。术后规范化化疗,可获得良好的生存率。保留生育功能患者应于化疗期间应用GnRHa进行卵巢功能保护。
英文摘要:
      Objective To investigate the effect of retroperitoneal lymph node dissection(LND)on the survival and prognosis of patients with early ovarian malignant germ cell tumors (MOGCTs).Methods By retrospectively analyzing the clinical data of 52 patients with early MOGCTs admitted to Anhui Provincial Hospital from November 2009 to July 2019,they were divided into two groups according to whether retroperitoneal lymph node dissection was performed,and 30 patients with retroperitoneal lymph node dissection were in the LND group,and 22 patients without retroperitoneal lymph node dissection were in the Non-LND group.The survival and recurrence rates of the two groups were compared to explore the impact of retroperitoneal lymph node dissection on the survival and prognosis of patients with early MOGCTs.Results No lymph node metastasis was found in 30 patients undergoing LND.Except for 8 patients with stage Ia dysgerminoma who did not need chemotherapy,the remaining 44 patients received chemotherapy after surgery.There was no statistically significant difference in the recurrence rate (10% vs 9.09%) between the LND and Non-LND groups (P=1.0).There were no statistically significant differences in the 5-year OS(100% vs 100%),the 5-year PFS(90% vs 95.45%),the 10-year OS(96.66% vs 100%)and the 10-year PFS(90% vs 90.90%) between the LND and Non-LND groups (P>0.05).Analysis of prognostic factors showed that age,tumor diameter,lymph node resection and pathological type had no significant effect on prognosis.Conclusion Early peritoneal lymph node dissection of MOGCTs has no significant effect on survival and prognosis,and patients with early MOGCTs may not undergo intraoperative LND.Standardized chemotherapy after surgery can achieve a good survival rate.Patients with fertility preservation should use GnRHa to protect ovarian function during chemotherapy.
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