oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2020-19-3-164-171oncotomsk-1501Research ArticleОБЗОРЫREVIEWSЗНАЧЕНИЕ ЦИТОРЕДУКТИВНЫХ ОПЕРАЦИЙ ПРИ РЕЦИДИВАХ РАКА ЯИЧНИКОВ С ИЗОЛИРОВАННЫМ ПОРАЖЕНИЕМ ЛИМФАТИЧЕСКИХ УЗЛОВTHE VALUE OF CYTOREDUCTIVE SURGERY FOR ISOLATED LYMPH NODE RECURRENCE OF OVARIAN CANCERМамажоновХ. И.MamajonovH. I.

аспирант отделения комбинированных и лучевых методов лечения онкогинекологических заболеваний,

115478, г. Москва, Каширское шоссе, 23

MD, Postgraduate, Department of Combined Modality Approaches to the Treatment of Gynecological Cancers,

23, Kashirskoye Shosse, 115478-Moscow

dr.hasanjon@mail.ruНикогосянС. О.NikoghosyanS. O.

доктор медицинских наук, ведущий научный сотрудник отделения комбинированных и лучевых методов лечения онкогинекологических заболеваний,

115478, г. Москва, Каширское шоссе, 23

MD, DSc, Leading Researcher, Department of Combined Modality Approaches to the Treatment of Gynecological Cancers, 

23, Kashirskoye Shosse, 115478-Moscow

ШевчукА. С.ShevchukA. S.

кандидат медицинских наук, заведующий отделением комбинированных и лучевых методов лечения онкогинекологических заболеваний,

115478, г. Москва, Каширское шоссе, 23

MD, PhD, Head of Department of Combined Modality Approaches to the Treatment of Gynecological Cancers,

23, Kashirskoye Shosse, 115478-Moscow

ФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияGynecological Department, N. N. Blokhin National Medical Research Centre of Oncology, Health Ministry of RussiaRussian Federation202006072020193164171Copyright © Мамажонов Х.И., Никогосян С.О., Шевчук А.С., 20202020Мамажонов Х.И., Никогосян С.О., Шевчук А.С.Mamajonov H.I., Nikoghosyan S.O., Shevchuk A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/1501

Цель исследования – провести систематический анализ данных, имеющихся в современной литературе, о роли циторедуктивных операций при комплексном лечении рецидивов рака яичников с изолированным поражением лимфатических узлов.

Материал и методы

Материал и методы. Поиск соответствующих источников производился в системах PubMed, Gynecol Oncol, Medline, NCCN, Elibrary, включались публикации с января 2006 г. по март 2019 г. Из 87 найденных исследований 26 были использованы для написания систематического обзора.

Результаты

Результаты. В течение многих лет рак яичников остаётся ведущей причиной смертности от онкогинекологических заболеваний. Первоначальное лечение для IC–IV стадий рака яичников включает в себя хирургическую циторедукцию с последующей платиносодержащей химиотерапией. Лучшие результаты отмечаются у пациенток с достигнутой полной циторедукцией: многие авторы сообщили об увеличении общей выживаемости больных по мере увеличения полноты циторедукций. Несмотря на это, у большинства пациенток развиваются рецидивы заболевания, а отдаленные результаты лечения остаются неудовлетворительными: показатель общей 5-летней выживаемости составляет около 30 %. Частота поражения лимфатических узлов при рецидивах рака яичников достоверно не известна, по данным литературы, изолированные рецидивы этой локализации отмечаются у 5–32 % пациенток. На сегодняшний день вопрос о значимости выполнения и объеме лимфодиссекции при лечении рецидивов рака яичников остается открытым. В связи с этим в данной статье мы хотим представить имеющуюся доказательную базу, касающуюся роли вторичных циторедуктивных вмешательств при рецидивах рака яичников у пациенток с изолированным поражением лимфатических узлов.

Заключение

Заключение. Рецидивы рака яичников с изолированным поражением лимфатических узлов могут свидетельствовать о прогностически более благоприятном течении заболевания. Роль вторичной циторедукции в этом контексте остается до конца не изученной, но данная категория пациенток может быть одной из наиболее подходящих для хирургического лечения рецидивов рака яичников. 

The purpose of the study was to undertake a systematic literature review regarding the role of cytoreductive surgery in treatment of recurrent ovarian cancer, as well as to summarize available data on various current studies and estimate indications for secondary cytoreduction in recurrent ovarian cancer with isolated lymph node involvement.

Material and Methods

Material and Methods. The search for relevant sources was carried out in PubMed, Gynecol Oncol, Medline, NCCN, Elibrary systems; publications were included from January 2006 up to March 2019. Of the 87 studies found, 26 were used to write a systematic review.

Results

Results. Ovarian cancer (OC) remains the leading cause of death from gynecological cancer. The initial treatment for IC-IV stages of OC includes surgical cytoreduction followed by platinum-containing chemotherapy. The best outcomes are observed in patients, in whom complete cytoreduction has been achieved. Despite this fact, most patients develop relapses and the 5-year survival rate is about 30 %. The frequency of lymph node involvement in patients with recurrent OC is not reliably known; isolated lymph node recurrence is reported to occur in 5–32 % of patients. To date, the problem regarding the extent of lymph node dissection in treatment of OC recurrence is still unsolved. In our paper we review the available data concerning the role of secondary cytoreductive surgery for isolated lymph node recurrence of ovarian cancer.

Conclusion

Conclusion. Isolated lymph node recurrence of ovarian cancer may indicate a more favorable prognosis and has a less aggressive pattern of OC relapse. The role of secondary cytoreduction in this context is not fully understood, but this category of patients may be one of the most suitable for surgical treatment of ovarian cancer recurrence. 

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The authors declare that there are no conflicts of interest present.