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02 December 2017, Volume 33 Issue 12 Previous Issue    Next Issue

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Indications and controversies of lymphadenectomy in ovarian cancer ZHANG Chen，LI Yi 2017, 33(12): 1223-1226.  DOI: 10.19538/j.fk2017120103 Abstract ( )   Surgery is the critical treatment and corner stone for ovarian cancer.Completeness of primary surgery is significantly associated with prognosis.As a common way of progression，lymph-node metastasis is also an essential index for evaluating severity of disease.Even though lymphadenectomy plays an important role，it has always been under controversy.This paper will focus on the indications and controversies of lymphadenectomy in ovarian cancer.

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Indications and controversies of lymphadenectomy in vulva cancer LIN Shao-dan，XIE Ling-ling 2017, 33(12): 1226-1230.  DOI: 10.19538/j.fk2017120104 Abstract ( )   Vulva radical local excision and inguinofemoral lymphadenectomy are the standard surgical approach to vulva cancer.FIGO and NCCN guidelines recommend that groin dissection is not necessary for Stage ⅠA carcinoma of the vulva and all patients with FIGO stageⅠB or stageⅡlesions should have an inguinofemoral lymphadenectomy.It is desirable to determine the status of the groin nodes prior to planning the overall treatment for advanced vulvar cancer.If there are no suspicious nodes before surgery，bilateral inguinofemoral lymphadenectomy may be performed.If nodes are clinically positive，a complete lymphadenectomy should be avoided.Only enlarged nodes from the groin and pelvis should be removed if feasible，and the patient is given postoperative groin and pelvic radiation.There are some controversies about lymph node resection.Most scholars reach consensus on the such controversial issues as both inguinal and femoral nodes removal，groin dissection performed through a triple incision approach，groin dissection performed through a transverse incision approach，and the preservation of the saphenous vein.The need to perform bilateral lymphadenectomy for midline primary tumors not invading midline structures and the operation indication of inguinofemoral lymphadenectomy for bartholin gland carcinoma and melanoma remain to be investigated.

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Indications and controversies of lymphadenectomy in endometrial cancer WANG Xin-yu 2017, 33(12): 1230-1233.  DOI: 10.19538/j.fk2017120105 Abstract ( )   Early-stage endometrial cancer is at risk of lymph node metastasis，but there is still controversy about the need for regional lymph node dissection in all patients.Depending on the preoperative and intraoperative evaluation，the decision is made whether the lymph node resection and the extent of lymph node excision will be performed.High-risk cases should be treated with systematic lymphadenectomy.

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Route and main points of retroperitoneal lymph node dissection for gynecological malignancies and the prevention and treatment of complications JIANG Fang，XIANG Yang 2017, 33(12): 1233-1237.  DOI: 10.19538/j.fk2017120106 Abstract ( )   Retroperitoneal lymph node dissection，including pelvic and para-aortic lymphadenectomy，is of great importance in gynecological malignancies treatment.Lymphadenectomy can be performed via transperitoneal or extraperitoneal route.The surgical approach used for a lymphadenectomy procedure in gynecological oncology is typically determined by the best approach for the total procedure，patient characteristics and surgeon’s experience.Surgery needs to be operated by an experienced gynecologic oncologist.The most frequent intraoperative and postoperative complication is vascular injury，followed by ureteral injury，bowel injury，neurologic injury，or perioperative infection.Late-postoperative complications consist mainly of symptomatic lymphatic lymphocyte（SPOL）  and lower extremity lymphedema（LEL）.Several techniques may decrease the incidence of SPOL and LEL.Thus，energy equipment should be rationally used during the procedure，the peritoneum should be left open and tube drains should be avoided.

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Indications and controversies of lymphadenectomy in cervical cancer WANG Wei，YAO Shu-zhong 2017, 33(12): 1237-1241.  DOI: 10.19538/j.fk2017120107 Abstract ( )   The indication of lymphadenectomy has been recommended by NCCN guideline and FIGO guideline.However，there is controversy in lymphadenectomy for cervical cancer.Surgical staging of women with locally advanced cervical cancer is feasible and safe.Sentinel lymph node dissection could not replace systematic lymphadenectomy nowadays.Para-aortic lymph node dissection is recommended for ⅠA2~ⅡA2 cervical cancer patients.The level of para-aortic lymph node dissection，up to inferior mesenteric artery，is enough.The dissection of enlarged and metastatic lymph nodes is recommended.

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Anatomy and physiological function of female pelvic，abdominal aorta and inguinal lymph nodes WANG Yan-zhou，YAO Yuan-yang 2017, 33(12): 1241-1245.  DOI: 10.19538/j.fk2017120108 Abstract ( )   Gynecologic malignant tumors are prone to lymph node metastasis.The pelvic，abdominal，aortic，and inguinal regions are the most frequent sites of metastasis.Most gynecologic malignancies require lymph node dissection/biopsy.However，the anatomic nomenclature of lymph nodes in pelvic，abdominal，aortic and inguinal regions is not standardized，and the common pathways of lymph node metastasis have not yet been fully elucidated.The lymph node metastasis of common malignant tumors is also controversial.This paper will focus on the discussion.