Prognostic significance of lymphadenectomyin malignant ovarian sex cord stromal tumor: A retrospective cohort study and meta-analysis
Prognostic significance of lymphadenectomyin malignant ovarian sex cord stromal tumor: A retrospective cohort study and meta-analysis
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淋巴结清扫术对恶性卵巢性索间质瘤的预后意义：回顾性队列研究和荟萃分析
DOI：
10.1016/j.ygyno.2017.10.022
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发表时间：
2018-01-01
影响因子：
4.7
通讯作者：
Zhang, Guiyu
中科院分区：
文献类型：
--
作者：
Cheng, Hongyan;Peng, Jin;Zhang, Guiyu
目标。评价淋巴结清扫术对恶性卵巢性索间质瘤（SCST）的预后意义。方法。回顾性分析齐鲁医院妇产科2005年4月至2016年12月期间接受初次手术的恶性卵巢SCST患者的病历。通过检索截至2017年7月20日的PubMed和Embase数据库进行荟萃分析。通过STATA统计软件19.0版计算合并比值比（OR）和95％置信区间（Cis）。结果。我们机构发现了 72 名恶性 SCST 患者。患者的平均年龄为44.3岁（范围8-80岁）。在 72 名患者中，69.4% 患有颗粒细胞瘤（GCT，n = 50）； 472% (n = 34) 接受了淋巴结切除术，52.8% (n = 38) 没有接受手术。没有一个淋巴结有病理证实的转移。除肿瘤分期外，SCST 或 GCT 患者的总生存率根据患者年龄、肿瘤大小、手术范围或细胞毒性化疗的施用情况没有显着差异（SCT 中 P = 0.010，GCT 中 P = 0.029）。淋巴结切除术对 SCST 或 GCT 患者的总生存率没有统计学意义的差异（P 分别为 0.734 和 0.079）。 在我们的荟萃分析中，通过检索策略共筛选出 179 项研究，最终纳入 13 项研究；已发现 3223 例病例，其中包括来自我们机构的病例。由于存在中等异质性，因此使用随机效应模型（12 = 43.8%，P = 0.040）。估计的汇总 OR 为 0.87（95% CI，0.57-1.31），表明淋巴结清扫术在改善 SCST 总生存率方面没有统计学意义（Z = 0.68，P = 0.496）。结论。肿瘤分期是影响SCSI总体生存的最重要的预后因素。淋巴结切除术对于提高 SCST 的总体生存率没有显着效果。由于淋巴结转移率极低，不建议在 SCST 的初始分期手术中进行淋巴结切除术。 (C) 2017 Elsevier Inc. 保留所有权利。
Objectives. To evaluate the prognostic significance of lymphadenectomy in malignant ovarian sex cord stromal tumor (SCST).Methods. The medical records of patients with malignant ovarian SCST who underwent primary surgery from April 2005 to December 2016 were retrospectively reviewed in the Department of Obstetrics and Gynecology of Qilu Hospital. A meta-analysis was performed by searching the PubMed and Embase database up to July 20, 2017. Pooled odds ratios (ORs) and 95% confidence intervals (Cis) were calculated by STATA statistical software version 19.0.Results. Seventy-two patients with malignant SCST were identified in our institution. The mean age of the patients was 44.3 years (range, 8-80 years). Among the 72 patients, 69.4% had granulosa cell tumors (GCTs, n = 50); 472% (n = 34) underwent lymphadenectomy, and 52.8% (n = 38) did not undergo the surgery. None of the lymph nodes had pathologically confirmed metastasis. No significant differences in overall survival of the patients with SCST or GCT were noted based on patient age, tumor size, surgery extent, or administration of cytotoxic chemotherapy, except tumor stage (P = 0.010 in SCTs and 0.029 in GCTs, respectively). Lymphadenectomy showed no statistically significant difference in overall survival of patients with SCST or GCT (P = 0.734 and 0.079, respectively).In our meta-analysis, a total of 179 studies were identified through a search strategy, and 13 studies were included eventually; 3223 cases were identified, including those from our institution. The random-effects model was used because of moderate heterogeneity (12 = 43.8%, P = 0.040). The estimated pooled OR was 0.87 (95% CI, 0.57-1.31), indicating that lymphadenectomy has no statistical significance in improving overall survival in SCSTs (Z = 0.68, P = 0.496).Conclusions. Tumor stage is the most important prognostic factor affecting SCSI overall survival. There is no significant effect of lymphadenectomy in improving the overall survival of SCSTs. Lymphadenectomy is not recommended in initial staging surgery of SCST due to the extremely low lymph node metastasis rate. (C) 2017 Elsevier Inc. All rights reserved.