手术治疗外阴恶性肿瘤54例临床分析

• 作 者: 李庆水 薛惠英 张锡芹 盛修贵 侯晓彤
• 机 构: 山东省肿瘤防治研究院,河南省安阳市人民医院,山东省肿瘤防治研究院,山东省肿瘤防治研究院,山东省肿瘤防治研究院
• 出 处: 齐鲁肿瘤杂志
• 发表日期: 1999年04期
• 关键词: 外阴恶性肿瘤 腹股沟淋巴结 临床分期 淋巴结阴性 外阴根治术 预后影响 外阴鳞状细胞癌 临床分析 淋巴结清除术 鳞癌

目的：探讨手术方式对外阴恶性肿瘤预后的影响。方法：对５４ 例经手术治疗的外阴恶性肿瘤病人进行回顾性分析。外阴广泛切除加腹股沟淋巴结清除者３５ 例，外阴广泛切除或单纯外阴切除１９例。结果：总１ 、３ 、５ 、１０ 、１５ 年生存率分别为９８１ ％ 、７０６ ％ 、４７６ ％ 、３８９ ％ 、３３３ ％ ；外阴鳞癌Ⅱ期１ 、３ 、５ 、１０ 年生存率分别为１０００ ％ 、６８４ ％ 、６６７ ％ 、７５ ．０ ％ ， Ⅲ期分别为１０００ ％ 、７２７ ％ 、４５５ ％ 、２００ ％ ；腹股沟淋巴结阳性者５ 年生存率为１５４ ％ ，而腹股沟淋巴结阴性者５ 年生存率为９０９ ％ 。结论：临床分期及腹股沟淋巴结转移情况对预后影响明显，临床分期不同手术方式的选择亦有差别，Ⅱ期病人应选择创伤小并发症少的手术方式，Ⅲ期病人则以外阴广泛切除加腹股沟淋巴结清除术最适宜。

Objective: To investigate the effect of surgical methods on the prognosis of vulvar and malignant tumors. Methods: 54 cases of vulvar malignant tumors after surgery were retrospectively analyzed. Vulvar extensive excision plus inguinal lymph node clearance in 35 cases, extensive vulvar removal or simple genital excision in 19 cases. Results: The overall survival rates at 1, 3, 5, 10 and 15 years were 981%, 706%, 476%, 389% and 333%, respectively. The 5-year and 10-year survival rates were 1000%, 684%, 667%, 75% respectively. 0% and Ⅲ were 1000%, 727%, 455% and 200% respectively. The 5-year survival rate of inguinal lymph node positive was 154%, while the 5-year survival rate of inguinal lymph node negative was 90  9%. Conclusion: The clinical stage and inguinal lymph node metastasis have a significant effect on the prognosis. There are also differences in the choice of clinical stages and surgical approaches. Stage II patients should choose less surgical procedures with less traumatic complications and stage III patients with extensive genital resection plus inguinal lymph nodes Removal of the most appropriate.