深浸润子宫内膜样腺癌前哨淋巴结(SLN)示踪与系统淋巴结切除的肿瘤学结局

2022-04-23 张师前 张师前

目的

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目的

比较前哨淋巴结活检(SLN)与盆腔和腹主动脉旁淋巴结切除术(LND)在深浸润子宫内膜样子宫内膜癌(EEC)治疗中的肿瘤学结局;比较淋巴结阴性病例的肿瘤学结局。

方法

在两个机构中,确定了深浸润(≥50%子宫肌层浸润)EEC的患者。一个机构采用LND(2004-2008),另一个机构采用SLN(2005-2013)。FIGO IV期病例被排除在外。记录特征和后续数据。

 

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结果

确定了176名患者(LND,94; SLN,82)。SLN患者更年轻(p = 0.003)并且LVSI比例更高(p <0.001)。SLN队列中9.8%和LND队列中29.8%未接受辅助治疗(p<0.001)。淋巴结评估类型与复发之间没有关联; PFS调整后的风险比(aHR; LNDvs SLN)0.87(95%CI 0.40,1.89)。在调整年龄和辅助治疗后,淋巴结评估方法与OS之间没有关联(aHR 2.54; 95%CI 0.81,7.91)。淋巴结阴性队列证明生存率和评估方法之间无关联:PFS aHR0.69(95%CI 0.23,2.03),OS 0.81(95%CI0.16,4.22)。在淋巴结阴性队列中,与无辅助治疗或仅IVRT相比,辅助EBRT +/- IVRT(HR 1.63; 95%CI 0.18,14.97)和辅助化疗+/- EBRT +/- IVRT(HR 0.49; 95%CI 0.11,2.22)均与OS无关。

 

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结论

在深浸润EEC中采用SLN方法评估淋巴结不会影响肿瘤学结局。无论评估方法如何,在淋巴结阴性病例中存活率更高。淋巴结阴性患者的辅助化疗似乎不会影响结果。

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    2022-04-25 sodoo
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