Patterns of metastasis in sex cord-stromal tumors of the ovary: Can routine staging lymphadenectomy be omitted?
Patterns of metastasis in sex cord-stromal tumors of the ovary: Can routine staging lymphadenectomy be omitted?
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DOI：
10.1016/j.ygyno.2008.12.007
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发表时间：
2009-04-01
影响因子：
4.7
通讯作者：
Gershenson, David M.
中科院分区：
文献类型：
--
作者：
Brown, Jubilee;Sood, Anil K.;Gershenson, David M.
目标。鉴于缺乏关于卵巢性索间质瘤（SCSTs）转移模式的数据，我们试图确定SCSTs患者淋巴结转移的风险。对1985年至2005年间在我院接受治疗的卵巢SCST患者的临床和病理数据库进行了回顾性分析。我们确定了262例经病理证实的卵巢SCSTs患者；5例有额外的非间质组织学，被排除在外。留下257名可评估的病人。在这些患者中，178例为成人颗粒细胞瘤，27例为青少年颗粒细胞瘤，31例为Sertoli-Leydig细胞瘤，6例为伴环状小管的性索肿瘤，13例为混合性SCSTs， 2例为未明确的SCSTs。我们的评估显示111例患者接受了完全或部分分期：75例为I期疾病，11例为11期疾病，25例为III期疾病。这111例患者中有58例（52%）在分期过程中切除了淋巴结。在初次手术中接受淋巴结取样的58例患者中，没有一例淋巴结呈阳性。117名患者的疾病最终复发。6例（5.1%）复发时已发生淋巴结转移。其中3例患者在初始阶段淋巴结阴性。卵巢SCSTs的淋巴结转移是罕见的。这些结果提示，卵巢SCSTs分期时可省略淋巴结切除术。(C) 2008爱思唯尔公司版权所有。
Objective. Given the paucity of data regarding the patterns of metastasis from ovarian sex cord-stromal tumors (SCSTs), we sought to determine the risk of lymph node metastasis in patients with SCSTs.Methods. A retrospective chart review was performed after clinical and pathology databases were queried for ovarian SCST patients who were treated at our institution between 1985 and 2005.Results. We identified 262 patients with pathology-confirmed ovarian SCSTs; 5 had additional non-stromal histology and were excluded. leaving 257 evaluable patients. Of these patients, 178 had adult granulosa cell tumors, 27 had juvenile granulosa cell tumors, 31 had Sertoli-Leydig cell tumors, 6 had sex cord tumors with annular tubules, 13 had mixed SCSTs, and 2 had SCSTs not otherwise specified. Our evaluation showed that 111 patients underwent a complete or partial staging procedure: 75 had stage I disease, 11 had stage 11 disease, and 25 had stage III disease. Fifty-eight of these 111 patients (52%) had lymph nodes removed as part of the staging procedure. Of the 58 patients who had lymph nodes sampled during the primary surgery, none had positive nodes. Of 117 patients whose disease eventually recurred. 6 patients (5.1%) had nodal metastases at the time of recurrence. Three of these patients had negative lymph nodes at initial staging.Conclusions. Lymph node metastasis in ovarian SCSTs is rare. These findings suggest that lymphadenectomy may be omitted when staging patients with ovarian SCSTs. (C) 2008 Elsevier Inc. All rights reserved.