Analysis of clinicopathologic factors predicting para-aortic lymph node metastasis in endometrial cancer
Analysis of clinicopathologic factors predicting para-aortic lymph node metastasis in endometrial cancer
复制标题
DOI：
10.1136/ijgc-00009577-200603000-00053
复制
发表时间：
2005-06
期刊：
影响因子：
--
通讯作者：
H. Nomura;D. Aoki;N. Suzuki;N. Susumu;A. Suzuki;Y. Tamada;F. Kataoka;Atsushi Higashiguchi;S. Ezawa;S. Nozawa
中科院分区：
文献类型：
--
作者：
H. Nomura;D. Aoki;N. Suzuki;N. Susumu;A. Suzuki;Y. Tamada;F. Kataoka;Atsushi Higashiguchi;S. Ezawa;S. Nozawa
本研究的目的是比较子宫内膜癌主动脉旁淋巴结转移与各种临床病理因素的关系，以评估在治疗子宫内膜癌时是否有必要进行主动脉旁淋巴结清扫。对841例在庆应义塾大学医院接受初次手术的子宫内膜癌患者进行了回顾性研究。单因素分析中与主动脉旁淋巴结转移显著相关的临床病理因素采用Logistic模型进行多因素分析。多因素分析显示，与腹主动脉旁淋巴结转移相关性最强的临床病理因素是盆腔淋巴结转移（P < 0.01）。采用Kaplan-Meier法分析155例接受盆腔及腹主动脉旁淋巴结清扫术的患者中是否存在腹膜后淋巴结转移对5年总生存率的影响。主动脉旁淋巴结转移阳性者行主动脉旁淋巴结清扫术，预后差。结论：子宫内膜癌患者在决定是否行腹主动脉旁淋巴结清扫术时，有必要考虑盆腔淋巴结的状况。如果没有盆腔淋巴结转移，则不需要进行腹主动脉旁淋巴结清扫。
The purposes of this study were to compare the relationships between para-aortic lymph node metastasis and various clinicopathologic factors to evaluate whether para-aortic lymph node dissection is necessary when treating endometrial cancer. A retrospective study was performed on 841 patients with endometrial cancer, who underwent the initial surgery at the Keio University Hospital. Clinicopathologic factors related to para-aortic lymph node metastasis significant on a univariate analysis were analyzed in a multivariate fashion using a logistic model. According to the multivariate analysis, the clinicopathologic factor most strongly related to the existence of para-aortic lymph node metastasis was positive pelvic lymph node metastasis (P < 0.01). Among the 155 patients who underwent pelvic and para-aortic lymph node dissection, the difference of 5-year overall survival by the presence of retroperitoneal lymph node metastasis was examined by Kaplan–Meier method. The prognosis was poor even if para-aortic lymph node dissection was performed in cases of positive para-aortic lymph node metastasis. In conclusion, when deciding whether to perform para-aortic lymph node dissection in patients with endometrial cancer, it is necessary to consider the pelvic lymph nodal status. If there is no pelvic lymph node metastasis, it could not be necessary to perform para-aortic lymph node dissection.