N因子对pT3C卵巢癌最佳减瘤手术预后的影响

Fumitoshi Terauchi, Takahisa Ishikawa, Ryoko Omura, Tetsuya Moritake, Rina Kato, Yasukazu Sagawa, Hirotaka Nishi, Hiroe Ito, Keiichi Isaka
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引用次数: 0

摘要

为达到完全切除而进行的原发性切除手术是晚期卵巢癌患者最重要的预后因素之一。然而,淋巴结转移与手术结果之间的关系尚不清楚。本研究分析N因子对pT3C卵巢癌行最佳手术(OpS)患者预后的影响。患者与方法研究对象为68例pT3C浆液性腺癌患者。采用Kaplan-Meier法和log-rank检验,根据肿瘤残余直径和淋巴结转移情况分析总生存期(OS)和中位生存期(MST)。患者接受骨盆腹膜后淋巴结清扫至腹主动脉旁淋巴结。将OpS组患者进一步分为完全手术无肿瘤残留组和肿瘤残留小于1 cm组,分析差异。结果OpS组和Sub-OpS组的总生存率分别为77.5%和11.1%。根据所有患者不同程度的淋巴结转移进行分析,N0和N1患者的总生存率分别为77.1%和47.5%;N1组预后明显较差。根据OpS组N因子分析,N1组即使有OpS,其预后也明显差于N0组(分别为53.7%和86.6%)。此外,在N1组OpS中,完全手术组的预后明显好于残留肿瘤小于1 cm的另一组(分别为77.8%和16.7%)。结论pT3CpN1卵巢癌合并OpS的预后与合并Sub-OpS的预后一样差。然而,结果表明,如果在OpS中完全切除肿瘤,预后可以得到改善。
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Effect of the N Factor on the Prognosis of pT3C Ovarian Cancer With Optimal Debulking Surgery

Introduction

The primary debulking surgery that is performed to achieve complete debulking is one of the most important prognostic factors in patients with advanced ovarian cancer. However, the relationship between lymph node metastases and the surgical outcome is still unclear. This study analyzed the effect of the N factor on the prognosis of patients with pT3C ovarian cancer who underwent optimal surgery (OpS).

Patients and Methods

The participants were 68 patients with pT3C serous adenocarcinoma. The overall survival (OS) and the median survival time (MST) were analyzed by the diameter of the residual tumor and by lymph node metastasis using the Kaplan-Meier method and the log-rank test. The patients received retroperitoneal lymph node dissection in the pelvic cavity up to the para-aortic lymph nodes. The patients in the OpS group were further divided into a complete-surgery group with no residual tumor and a group with residual tumor of less than 1 cm, and differences were analyzed.

Results

The OS rates in the OpS group and Sub-OpS group were 77.5% and 11.1%, respectively. According to the analyses made by different levels of lymph node metastasis in all patients, the OS rates in patients with N0 and N1 disease were 77.1% and 47.5%, respectively; the prognosis was significantly poorer in the N1 group. According to the analyses of the N factor in the OpS group, the prognosis was significantly poorer in the N1 group even with OpS compared with that in the N0 group (53.7% and 86.6%, respectively). Furthermore, in the N1 group with OpS, the prognosis was significantly better in the complete-surgery group than in the other group with residual tumor of less than 1 cm (77.8% and 16.7%, respectively).

Conclusion

The prognosis of pT3CpN1 ovarian cancer with OpS was as poor as with Sub-OpS. However, the results suggested that the prognosis could be improved if the tumor was completely resected in OpS.

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WITHDRAWN: Epigenetic Pathways Offer Targets for Ovarian Cancer Treatment Table of Contents Editorial Board A Simulation Study of the Factors Influencing the Risk of Intraoperative Slipping Genetic Cancer Ovary
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