关键词: 卵巢癌, 淋巴结, 复发, 总生存期

Abstract:

Objective To explore the impact of the number of negative lymph node resections on the overall survival and recurrence rate of patients with ovarian cancer. Methods A retrospective selection was made of 150 ovarian cancer patients admitted to our hospital from October 2021 to October 2023 as the research subjects. According to the standard of the number of negative lymph nodes removed， they were divided into three groups： T1 group （≤ 17）， T2 group （18 ~ 27）， and T3 group （≥ 28）. Clinical characteristics and surgical indicators were collected， and the recurrence and survival situations were analyzed. Results The clinical characteristic analysis results showed that there were no statistically significant differences among the three groups in terms of age， menopausal status， BMI， CCI， family history of tumors， etc. （P > 0.05）. There were no significant differences in surgical methods， residual lesion size， postoperative complications among the three groups （P > 0.05）. In terms of operation time， T1 group < T2 group < T3 group （P < 0.05）， and the bleeding volume in T3 group was more than that in T1 group （P < 0.05）. There was no significant difference in the overall recurrence rate among the three groups （P > 0.05）， but with the increase in the number of lymph node resections （from T1 group to T3 group）， the recurrence rate showed a statistically significant downward trend （P < 0.05）. Cox regression analysis showed that the univariate analysis indicated that for each additional negative lymph node， the risk of death decreased by 4.7% （HR = 0.953， P < 0.05）； the multivariate analysis （after adjusting for confounding factors） showed that the risk decreased by 5.8% （HR = 0.942， P < 0.05）. Restricted cubic spline （RCS） analysis confirmed a significant linear association between the two （P < 0.05）. With 5 lymph nodes as the reference， the risk ratios for 10， 20， and 30 resections were 1.003， 0.760， and 0.317， respectively， and the trend showed that the risk of death continued to decrease as the number of lymph nodes increased. Multivariate Cox analysis showed that the risk of death in T3 group was 68% lower than that in T1 group （P < 0.05）， the risk in FIGO stage Ⅲ was 3.11 times higher （P < 0.05）， and the risk in high-grade tumors was 2.80 times higher （P < 0.05）. Conclusions The number of negative lymph nodes removed in patients with ovarian cancer is linearly correlated with prognosis. The more lymph nodes removed， the lower the risk of death for the patients. Adequate lymph node removal should be an important part of the surgical treatment for ovarian cancer.

Key words: ovarian cancer, lymph nodes, recurrence, overall survival