晚期卵巢癌中的心脏性淋巴结
Nuria Agusti1, Giulio Bonaldo2, Ryan M Kahn3
1Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA NAgusti@mdanderson.org.
概括
在晚期卵巢癌中切除心脏性淋巴结仍在争论中. 虽然病理结节表明预后较差,但通过手术切除它们的生存益处仍然没有确定性.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 妇科瘤学 妇科瘤学
背景情况:
- 表皮卵巢癌经常呈现于晚期,预后与细胞减少后的残留疾病有关.
- 在晚期卵巢癌的细胞还原性手术期间心脏性淋巴结切除的作用受到争议.
- 目前的卵巢癌指导方针没有明确心性淋巴结切除的指示.
研究的目的:
- 评估心脏性淋巴结切除在晚期上皮卵巢癌中的意义和影响.
- 阐明最佳的成像技术,以评估心性淋巴结的切除能力.
- 确定心性淋巴结切除对患者生存结果的影响.
主要方法:
- 对检测扩大心淋巴结的成像技术的审查.
- 对心脏性淋巴结切除的手术方法 (开放式或微创手术) 的分析.
- 评估与心性淋巴结切除相关的并发症.
主要成果:
- 扩大的心性淋巴结可以通过高分辨率成像识别,但评估切除能力的最佳技术尚不清楚.
- 切除节点>1厘米可以考虑切除,如果完全的腹腔内细胞减少到没有严重的残留疾病是可以实现的.
- 心性淋巴结切除的主要并发症并不常见,既可以采用开放式的方法,也可以采用微创的方法.
- 病态心脏性淋巴结与预后较差相关,可以作为预后标志物.
结论:
- 心脏性淋巴结切除在晚期卵巢癌中的治疗益处仍然没有确定性.
- 虽然病理节点是预后性的,但它们的常规切除需要进一步调查以确定生存益处.
- 需要为卵巢癌中心性淋巴结管理制定标准指南.
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