化疗对晚期卵巢、输卵管及腹膜浆液性癌淋巴结转移的临床疗效(附70例临床分析)

目的:探讨化疗对晚期卵巢、输卵管及腹膜浆液性癌腹膜后淋巴结转移的临床疗效。方法:将晚期卵巢、输卵管及腹膜浆液性癌70例患者,根据淋巴结切除术与化疗的先后顺序分为2组:A组21例,化疗后行淋巴结切除术。B组49例,淋巴结切除术后化疗。比较2组患者的一般情况、治疗方案及淋巴结转移情况。结果:2组患者的年龄,肿瘤分期分级,治疗前的肿瘤标记物,切除淋巴结的数量等均无显著性差异(P>0.05)。初治时A组患者盆腹腔黏连及转移重于B组;初次手术A组进行满意的肿瘤细胞减灭术的几率明显低于B组(0%vs73.47%,P<0.05)。化疗后A组患者淋巴结转移率低于B组(38.10%vs49.00%,P>0.05),腹主动脉旁淋巴结为肿瘤最常侵犯的淋巴结。A组行TC(泰素/紫杉醇+伯尔定/卡铂)或TP(泰素/紫杉醇+顺铂)方案化疗的患者淋巴转移率低于行CAP(顺铂+阿霉素+环磷酰胺)方案的患者(33.33%vs50%,P=0.045)。结论:化疗对卵巢、输卵管及腹膜浆液性癌淋巴结转移有一定的疗效。初治时不能进行淋巴结切除的患者可考虑先行化疗后再次手术切除淋巴结。

Clinical analysis of chemotherapy to lymph node metastasis in 70 cases with advanced epithelial ovarian carcinoma after interval-cyctoreduction

Objective:To investigate the effects of chemotherapy on retroperitoneal lymph node metastasis in advanced ovarian,fallopian tube and peritoneal serous carcinoma.Methods:Seventy patients with advanced serous ovarian carcinoma,fallopian tube carcinoma or peritoneal carcinoma were divided into two groups:21 cases of group A underwent pelvic and para-aortic lymphadenectomy after chemotherapy;49 cases of group B underwent initial lymphadenectomy before chemotherapy.The general condition,chemotherapy,pre-treatment,lymph node metastasis rate,the effect of chemotherapy on retroperitoneal lymph node metastasis were compared between two groups.Results:There were no significant differences between two groups in age,tumor grade and stage,pre-treatment tumor markers,the number of lymph nodes dissected and other clinical factors.Before surgery,the abdominal or pelvic adhesion and metastasis were significantly worse in group A than those in group B.During initial operation,the optimal cytoreductive surgery probability of group A was significantly lower than that of group B(0% vs 73.47 %,P<0.05).The lymph node metastasis rate of group A was lower than group B(38.10% vs 49.00%,P>0.05).The probability of para-aortic lymph node metastasis was the most frequent.The rate of lymph node metastasis received Taxol/paclitaxel + Paraplatin /carboplatin or Taxol/paclitaxel+cisplatin chemotherapy was significantly lower than those received cisplatin+adriamycin+cyclophosphamide chemotherapy(33.33% vs 50%,P=0.045).Conclusion:Chemotherapy has some effects decreased retroperitoneal lymph node metastasis in advanced ovarian serous carcinoma.If patient who couldn't performed lymphadenectomy for some reasons during initial cytoreductive surgery,chemotherapy may be beneficial.