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目的:探讨不同术式对早期卵巢颗粒细胞瘤初治患者预后的影响。方法:收集2000年1月～2008年12月我院收治的39例早期卵巢颗粒细胞瘤患者的临床资料,分析不同术式对肿瘤复发和预后的影响。结果:39例患者中,行全面分期手术者20例,其中7例仅予盆腔及腹主动脉旁淋巴结活检而未予淋巴结清扫,所有淋巴结术后病理皆提示无淋巴转移;19例行非全面分期手术。随访期间,全面分期手术组皆无复发,而非全面分期手术组4例复发,两组患者术后3年的复发率分别为0和21%,具有统计学差异(P<0.05);非全面分期手术组有1例患者于术后29月死亡,死亡年龄为72岁,全面分期手术组无死亡病例,两组患者的死亡率不具有统计学差异(P>0.05)。结论:原发性卵巢颗粒细胞瘤罕有淋巴结转移,早期卵巢颗粒细胞瘤行全面分期手术对于明确肿瘤分期、治疗及预后有重要意义,而全面分期手术中行盆腔及腹主动脉旁淋巴结清扫对于肿瘤的复发意义有限,初治患者全面分期手术时可不予淋巴清扫。
Objective: To investigate the effect of different surgical procedures on the prognosis of patients with early stage ovarian granulosa cell carcinoma. Methods: The clinical data of 39 patients with early ovarian granulosa cell carcinoma treated in our hospital from January 2000 to December 2008 were collected. The effects of different surgical procedures on tumor recurrence and prognosis were analyzed. Results: Of the 39 patients, 20 patients underwent total staging surgery, of which 7 patients were only given pelvic and para-aortic lymph node biopsy without lymph node dissection, and all postoperative pathology showed no lymph node metastasis; 19 patients had incomplete lymph node metastasis Staging surgery. During the follow-up period, no recurrence was found in the total staging group, but 4 cases were recurrent in the non-comprehensive staging group. The recurrence rates after 3 years of the two groups were 0 and 21%, respectively, with statistical significance (P <0.05) One patient in staging group died at 29 months after operation, the death age was 72 years. There was no death in the comprehensive staging group. There was no significant difference in mortality between the two groups (P> 0.05). CONCLUSIONS: There are rare lymph node metastases in primary ovarian granulosa cell tumor. The comprehensive staging of early ovarian granulosa cell tumor is of great significance for the definite tumor staging, treatment and prognosis. However, pelvic and para-aortic lymph node dissection in complete staging surgery is of great significance for tumor Recurrence of limited significance, the initial treatment of patients with complete staging may not lymph dissection.