臨床婦人科産科74巻11号

2020年11月発行

原著

術前に再発低リスクと予想される子宮体がん症例におけるリンパ節郭清術の省略に関する検討

著者： 江口聡子¹ 山口広平¹ 石坂彩¹ 神野雄一¹ 竹内真¹ 早田季美恵¹ 永井美和子¹ 後藤美希¹ 横尾郁子¹ 東梅久子¹ 有本貴英¹

所属機関： ¹虎の門病院産婦人科

ページ範囲：P.1177 - P.1181

▶要約

　子宮体がん手術におけるリンパ節郭清術の治療的意義は明確でなく，術前にリンパ節転移リスクが低いと予測される症例においてはリンパ節郭清術の省略が考慮される．リンパ節転移低リスク群の抽出システムはいまだ標準化されていないが，当院では術前評価で類内膜がんGrade 1かつ筋層浸潤1/2未満と予測される症例において，リンパ節郭清術を省略している．これらの53症例におけるclinical outcomeを解析し，子宮体がん手術におけるリンパ節郭清術省略の可否について検討した．組織型，筋層浸潤の術前評価の正診率はそれぞれ100％，94.3％と高かった．術前評価（組織型，筋層浸潤）に加えて，術中所見（肉眼での筋層浸潤，迅速腹腔細胞診）によってリンパ節郭清術の省略を決定することが妥当と考えられた．

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