Frequency and characteristics of isolated para-aortic lymph node recurrence in patients with uterine cervical carcinoma in Japan: A multi-institutional study
Frequency and characteristics of isolated para-aortic lymph node recurrence in patients with uterine cervical carcinoma in Japan: A multi-institutional study
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DOI：
10.1016/j.ygyno.2006.03.034
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发表时间：
2006-11-01
影响因子：
4.7
通讯作者：
Hayakawa, Kazushige
中科院分区：
文献类型：
--
作者：
Niibe, Yuzuru;Kazumoto, Tomoko;Hayakawa, Kazushige
Objective.在大多数宫颈癌复发病例中，据报道，远处转移或复发的第一个部位是腹主动脉旁区域。有报道显示，经放射治疗的孤立性主动脉旁淋巴结复发患者均能长期存活，提示宫颈癌孤立性主动脉旁淋巴结复发是一种局部性疾病，而非全身性疾病。确定原发性宫颈癌患者初次治疗时孤立性主动脉旁淋巴结复发的预测特征非常重要，因此我们进行了当前的多机构研究。1994年至2003年期间，在12家日本医院治疗了Ia至IVa期宫颈癌患者（n=3137）。本研究探讨了孤立性腹主动脉旁淋巴结复发患者的频率和特点，以及患者的临床分期、组织病理学、血清鳞状细胞癌抗原水平、初始治疗时的治疗方法、初始治疗至复发的时间以及复发时血清鳞状细胞癌抗原水平的特点。在3137例Ia-IVa期宫颈癌患者中，67例（2.1%）在孤立的主动脉旁淋巴结中复发。按临床分期分层，613例Ia期患者中无一例发生孤立性主动脉旁淋巴结复发。然而，14例患者复发，Ib期966例，占1.4%，199例IIa期患者中，14例（3.5%）（2.3%）613例IIb期患者中，1例IIIa期患者48例，占2.1%; IIIb期患者538例，占4.6%; IVa期患者100例，占5%。初始治疗和孤立性主动脉旁复发之间的平均持续时间为20个月（范围，2-49个月）。研究治疗持续时间与临床病理因素（临床分期、组织病理学、血清鳞状细胞癌抗原水平和治疗方法）之间的相关性。在目前的研究中没有发现统计学上显著的因素。在本研究中，孤立性主动脉旁淋巴结复发的频率为2.1%，并随着初始治疗时临床分期的增加而增加（IVa期：5%）。(c)2006年爱思唯尔公司All rights reserved.
Objective. In most cases of uterine cervical carcinoma recurrence, the first site of distant metastasis or recurrence is reported to be the para-aortic region. Some reports have demonstrated that, in cases of isolated para-aortic lymph node recurrence treated by radiation therapy, patients survived for a long period, which suggests that isolated para-aortic lymph node recurrence in uterine cervical carcinoma is a regional disease rather than systemic disease. Determining the predictive characteristics of isolated para-aortic lymph node recurrence in patients at the time of the initial treatment for primary uterine cervical carcinoma is important, so we conducted the current multi-institutional study.Patients and methods. Patients (n=3137) with uterine cervical carcinoma of stages Ia to IVa were treated in twelve Japanese hospitals between 1994 and 2003. The current study investigated the frequency and characteristics of patients with isolated para-aortic lymph node recurrence as well as the characteristics of clinical stage, histopathology, serum squamous cell carcinoma antigen level, the treatment method at the initial treatment, the duration between the initial treatment and the recurrence, and the serum squamous cell carcinoma antigen level at the recurrence.Results. Of the 3137 patients with uterine cervical carcinoma in stages Ia-IVa, 67 (2.1%) experienced recurrence in isolated para-aortic lymph nodes. Stratified by clinical stage, none of the 613 patients with stage Ia experienced recurrence in isolated para-aortic lymph nodes. However, recurrence was experienced by 14 (1.4%) of the 966 patients with stage Ib, 7 (3.5%) of the 199 patients with stage IIa, 14 (2.3%) of the 613 patients with stage IIb, 1 (2.1%) of the 48 patients with stage IIIa, 26 (4.6%) of the 538 patients with stage IIIb, and 5 (5%) of the 100 patients with stage IVa. The mean duration time between the initial treatment and isolated para-aortic recurrence was 20 months (range, 2-49 months). The correlations between duration time and the clinico-pathological factors (clinical stage, histopathology, serum squamous cell carcinoma antigen level, and treatment method) at the initial treatment were investigated. No statistically significant factors have been revealed in the current study.Conclusions. The frequency of isolated para-aortic lymph node recurrence was 2.1% and increased with increasing clinical stage at the initial treatment (stage IVa: 5%) in the current study. (c) 2006 Elsevier Inc. All rights reserved.