Pattern of lymph node metastasis and the optimal extent of pelvic lymphadenectomy in FIGO stage IB cervical cancer
Pattern of lymph node metastasis and the optimal extent of pelvic lymphadenectomy in FIGO stage IB cervical cancer
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DOI：
10.1111/j.1447-0756.2007.00526.x
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发表时间：
2007-06-01
影响因子：
1.6
通讯作者：
Park, Chan-Yong
中科院分区：
文献类型：
--
作者：
Lee, Jong-Min;Lee, Kwang-Beom;Park, Chan-Yong
目的：探讨FIGO IB期宫颈癌盆腔淋巴结转移的分布规律，确定盆腔淋巴清扫的最佳范围。方法：回顾分析1996年3月至2002年12月收治的187例FIGO IB期宫颈癌患者的临床资料。对31例经手术证实的淋巴结转移患者的分布规律及危险因素进行了分析。对100例接受III型子宫切除并盆腔LA但未接受任何辅助治疗的患者进行分析，以评估LA的范围是否影响FIGO期IB期宫颈癌的预后。I型LA包括髂外结节、腹下结节、闭孔结节和宫旁结节。II型LA包括I型LA型中描述的盆腔淋巴结、髂总淋巴结、臀部淋巴结、腹股沟深部淋巴结，有时还包括骶前淋巴结。结果：闭孔、髂外或腹下淋巴结可见单发转移。所有在多个部位有淋巴结转移的患者在这些淋巴结组中至少有一个有转移。无病理性高危因素患者的无病生存期和总生存期按盆腔LA类型的不同无明显差异。结论：对于无病理性高危因素的FIGO IB期宫颈癌患者，应调整LA范围，以减少并发症，不影响预后。
Aim: To evaluate the distribution pattern of lymph node metastasis and to determine the optimal extent of pelvic lymphadenectomy (LA) in FIGO stage IB cervical cancer.Methods: The medical records of 187 patients with FIGO stage IB cervical cancer from March 1996 to December 2002 were reviewed retrospectively. The distribution pattern and risk factors of lymph node metastases were analyzed in 31 patients with lymph node metastases confirmed surgically. One hundred patients, who underwent type III hysterectomy with pelvic LA but did not receive any adjuvant treatment, were analyzed to evaluate whether the extent of LA affected the prognosis of FIGO stage IB cervical cancer. Type I LA included the external iliac nodes, hypogastric nodes, obturator nodes, and parametrial nodes. Type II LA included the pelvic nodes described in type I LA, the common iliac nodes, gluteal nodes, deep inguinal nodes and sometimes the presacral nodes.Results: Solitary lymph node metastasis confined to one node group was seen in the obturator, external iliac or hypogastric lymph nodes. All patients with lymph node metastases at multiple sites had metastasis in at least one of these lymph-node groups. There was no significant difference in disease-free survival and overall survival in patients without pathologic high-risk factors according to the type of pelvic LA.Conclusion: The extent of LA should be adjusted to reduce complications and not to affect adversely the prognosis of FIGO stage IB cervical cancer patients without pathologic high-risk factors.