摘要
Abstract
Objective:To evaluate the relationship between the application of lymphadenectomy and overall survival in patients with FIGO stage Ⅱ-Ⅳ ovarian mucinous carcinoma,and to explore whether this relationship differs by lymph node metastasis status.Methods:Based on the Surveillance,Epidemiology,and End Results(SEER)database,we retrospectively identified the patients diagnosed with primary FIGO stage Ⅱ-Ⅳ ovarian mucinous carcinoma from 2004 to 2021.Clinical characteristics were compared between the patients who underwent lymphadenectomy and those who did not.Cox proportional hazard models were used to assess the association of lymphadenectomy and other clinical factors with overall survival,with stratified analysis conducted according to lymph node metastasis status.Results:A total of 726 patients were included,of whom 340(46.8％)underwent lymphadenectomy.Among the 336 patients with pathological records of lymph nodes,95(28.3％)had lymph node metastasis.Compared with patients of the non-lymphadenectomy group,patients of the lymphadenectomy group were younger,had earlier FIGO stages and higher proportion of unilateral tumors,and were more likely to receive chemotherapy(all P<0.05).Multivariable Cox proportional hazard models analysis showed that lymphadenectomy was independently associated with longer overall survival(aHR=0.58,95％CI:0.48-0.70,P<0.001).Stratified analysis by lymph node metastasis status revealed that,compared with the patients of the non-lymphadenectomy group,the patients without lymph node metastasis who underwent lymphadenectomy had significantly longer overall survival(HR=0.41,95％CI:0.33-0.50,P<0.001),while no significant association was observed between lymphadenectomy and overall survival in those patients with lymph node metastasis(HR=0.87,95％CI:0.67-1.12,P=0.281).Conclusions:The clinical value of lymphadenectomy in FIGO stage Ⅱ-Ⅳ ovarian mucinous carcinoma may primarily lie in accurate staging and prognostic stratification.However,direct survival benefit remains to be further verified.Clinical decision-making should comprehensively balance the surgical tolerance and the risk of nodal metastasis.关键词
卵巢肿瘤/腺癌,黏液/淋巴结切除术/淋巴转移/比例危险度模型Key words
Ovarian neoplasms/Adenocarcinoma,mucinous/Lymph node excision/Lymphatic metastasis/Proportional hazards models
