早期子宮頸癌：子宮根除手術可考慮不做例行的骨盆淋巴摘除

Routine Pelvic Lymphadenectomy for early-stage cervical cancer questioned

在早期子宮頸癌，IB-IIA，子宮旁組織和骨盆淋巴是否有侵犯，影響復發和預後至大。20 多年前，我們當時所做的一個前瞻性研究－－核磁共振，以鑑定33 位早期子宮頸癌病人，手術前的子宮旁組織和骨盆淋巴癌症侵犯情況。發現核磁共振的預測非常準確，因此，手術前影像沒有淋巴的侵犯，手術時又沒有發現淋巴腫大，早期子宮頸癌病人的子宮根除手術，可以考慮不做骨盆淋巴摘除。

Radical hysterectomy, a therapeutic modality for the treatment of early-stage cervical cancer, is routinely combined with pelvic lymphadenectomy. A pretreatment evaluation by magnetic resonance imaging (MRI) to predict the parametrial spreading and metastasis to the pelvic lymph nodes, compared with the pathologic assessment, showed that the overall accuracy rate of prediction is greater than 90%, and the negative prediction is 100%. It may therefore suggest that routine pelvic lymphadenectomy is not necessary if the pelvic lymph node involvement in the pretreatment MRI is negative and the gross examination of the pelvic lymph node during operation is also negative.