CAJ | 학술논문

目的：探讨腹膜后淋巴结切除术对卵巢内胚窦瘤患者肿瘤复发和预后的影响。方法回顾性分析1996年2月至2010年3月收治的52例卵巢内胚窦瘤患者的临床资料，根据手术方案不同分为两组：淋巴结切除组22例，行肿瘤切除术及腹膜后淋巴结切除术；淋巴结未切除组30例，未接受腹膜后淋巴结切除，仅行肿瘤切除术。比较两组患者复发率，并分析影响患者复发率的临床因素。结果腹膜后淋巴结切除组在复发率、复发平均间隔时间方面与淋巴结未切除组相比均无明显差异(P >0.05)。临床分期、是否采用BEP方案化疗及术后甲胎蛋白恢复正常所需化疗疗程数是影响肿瘤复发的显著性因素(P<0.05)，其中化疗方案及术后甲胎蛋白恢复正常所需化疗疗程数影响最大(P<0.01)，是否有腹膜后淋巴结转移对患者的预后并无明显影响。结论内胚窦瘤患者不能从腹膜后淋巴结切除术中获益，术后规范化的化疗更有助于改善患者的预后。
목적：탐토복막후림파결절제술대란소내배두류환자종류복발화예후적영향。방법회고성분석1996년2월지2010년3월수치적52례란소내배두류환자적림상자료，근거수술방안불동분위량조：림파결절제조22례，행종류절제술급복막후림파결절제술；림파결미절제조30례，미접수복막후림파결절제，부행종류절제술。비교량조환자복발솔，병분석영향환자복발솔적림상인소。결과복막후림파결절제조재복발솔、복발평균간격시간방면여림파결미절제조상비균무명현차이(P >0.05)。림상분기、시부채용BEP방안화료급술후갑태단백회복정상소수화료료정수시영향종류복발적현저성인소(P<0.05)，기중화료방안급술후갑태단백회복정상소수화료료정수영향최대(P<0.01)，시부유복막후림파결전이대환자적예후병무명현영향。결론내배두류환자불능종복막후림파결절제술중획익，술후규범화적화료경유조우개선환자적예후。
Objective To evaluate the impact of lymphadenectomy on the relapse and survival of ovarian endodermal sinus tumor. Methods The clinical data of 52 OYST cases treated in Jiangsu Cancer Hospital from Feb. 1996 to Mar. 2010 were analyzed retrospectively. According to surgical procedure,all cases were divided into two groups:research group with 22 cases received cytoreductive surgery plus retroperitoneal lymphadenecto-my,and control group with 30 cases did not receive retroperitoneal lymphadenectomy. The indexes of recurrence rate were compared between two groups and the independent factors related to relapse of disease were identified. Results There was no statistical difference in the recurrence rate and mean recurrence duration between two groups (P>0. 05). International Federation of Gynecology and Obstetrics (FIGO) staging,chemotherapy regi-men,and required chemotherapy courses that got the serum AFP levels back to normal were the significant fac-tors related to the relapse. Moreover,the presence of lymph node metastasis had no significant effect on relapse. Conclusion Lymphadenectomy may not bring benefitial effect for patients and standardized chemotherapy can improve the prognosis of patients with OYST.