Pattern of lymph node metastases in clinically unilateral stage invasive epithelial ovarian carcinomas
Pattern of lymph node metastases in clinically unilateral stage invasive epithelial ovarian carcinomas
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DOI：
10.1006/gyno.2000.6027
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发表时间：
2001-01-01
影响因子：
4.7
通讯作者：
Karlan, BY
中科院分区：
文献类型：
--
作者：
Cass, I;Li, AJ;Karlan, BY
目的。关于单侧I期浸润性卵巢癌的淋巴扩散模式存在争议。本研究的目的是描述临床上局限于一个卵巢的卵巢癌中淋巴结转移的发生率和分布。96例疾病明显局限于一侧卵巢。病理报告进行审查，以确定转移性淋巴结受累，受累淋巴结的数量，和他们的位置。在骨盆或腹部有明显疾病的患者或因减积而切除了严重阳性ln的患者被排除在本综述之外。96例患者中有14例（15%）在病理检查中显微镜下呈阳性。这14例患者均为3级肿瘤。3级肿瘤在ln阳性和ln阴性患者中更常见（P < 0.001）。7例（50%）患者盆腔淋巴结阳性，5例（36%）患者主动脉旁淋巴结阳性，2例（14%）均阳性。42例患者仅在肿瘤卵巢同侧进行淋巴结取样，其中4例（10%）有淋巴结转移。54例患者进行了双侧取样，其中10例（19%）有淋巴结转移。在这10例患者中，有5例（50%）出现孤立的同侧淋巴结转移。孤立性对侧淋巴结转移3例（30%），双侧转移2例（20%）。在这组局限于一个卵巢的临床I期卵巢癌患者中，双侧淋巴结取样增加了淋巴结转移的识别。同侧取样可能导致患者分期不足。建议双侧盆腔和主动脉旁淋巴结取样以准确分期卵巢癌。(C) 2001学术出版社。
Purpose. There is controversy regarding the pattern of lymphatic spread in unilateral stage I invasive ovarian carcinomas. The purpose of this study is to describe the incidence and distribution of lymph node (LN) metastases in ovarian carcinomas clinically confined to one ovary.Methods. Ninety-six patients with disease visibly confined to one ovary were identified. Pathology reports were reviewed to identify metastatic LN involvement, number of involved nodes, and their locations. Patients with gross disease in the pelvis or abdomen or those who had grossly positive LNs removed for debulking were excluded from this review.Results. Fourteen of ninety-six patients (15%) had microscopically positive LNs on pathologic review. All of these 14 patients had grade 3 tumors. Grade 3 tumors were more commonly seen in LN-positive versus LN-negative patients (P < 0.001). Pelvic nodes were positive in 7 patients (50%), paraaortic nodes in 5 patients (36%), and both in 2 patients (14%). Forty-two patients had LN sampling only on the side ipsilateral to the neoplastic ovary, 4 of whom (10%) had LN metastases. Fifty-four patients had bilateral sampling performed, 10 of whom (19%) had LN metastases. Of these 10 patients, isolated ipsilateral LN metastases were seen in 5 (50%) cases. Isolated contralateral LN metastases were seen in 3 (30%) cases, and bilateral metastases were seen in 2 (20%).Conclusions. In this cohort of patients with clinical stage I ovarian carcinoma with disease limited to one ovary, bilateral LN sampling increased the identification of nodal metastases. Ipsilateral sampling may result in the understaging of patients. Bilateral pelvic and paraaortic LN sampling is recommended to accurately stage ovarian carcinoma. (C) 2001 Academic Press.