A meta-analysis of survival after minimally invasive radical hysterectomy versus abdominal radical hysterectomy in cervical cancer: center-associated factors matter.
A meta-analysis of survival after minimally invasive radical hysterectomy versus abdominal radical hysterectomy in cervical cancer: center-associated factors matter.
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DOI：
10.1007/s00404-021-06348-5
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发表时间：
2022-09
影响因子：
2.6
通讯作者：
中科院分区：
文献类型：
--
作者：
目的探讨在宫颈癌的无进展生存期(PFS)和总生存期(OS)方面，导致微创手术(MIS)与开腹手术相比表现不佳的可能因素。检索Medline、EMBASE、Cochrane图书馆和Web of Science(2000-01/2021-04)。研究选择由两名研究人员进行，包括已报道的肿瘤安全性研究。综合危险比(HR)和95%可信区间(CI)采用随机效应模型。亚组分析按疾病、出版物、研究设计和治疗中心的特点进行分层。包括63,369名患者的61项研究(管理信息系统26956例，ARH 36,049例)。总体分析显示，在肿瘤大小小于2 cm的FIGO IB1(FIGO 2009分期)患者中，与ARH相比，MISI后复发和死亡的风险更高(HR 1.209；95%CI 1.102-1.327)和死亡(HR 1.124；95%CI 1.013-1.248)。然而，亚组分析显示，在发表在欧洲期刊上的腹腔镜宫颈癌(LACC)试验之前的研究中，PFS/DFS和OS具有可比性，这些研究在一个中心进行，在欧洲的中心和高样本量或高MIS样本量的中心进行。我们的研究结果强调了影响宫颈癌患者术后生存率较低的可能因素，包括出版物特征、中心地理位置和样本量。在评估根治性子宫切除术等复杂的外科手术时，需要考虑中心相关因素。网上版载有补充材料，可在10.1007/s00404-021-06348-5查阅。
To explore the possible factors that contributed to the poor performance of minimally invasive surgery (MIS) versus abdominal surgery regarding progression-free survival (PFS) and overall survival (OS) in cervical cancer. MEDLINE, EMBASE, Cochrane Library and Web of Science were searched (January 2000 to April 2021). Study selection was performed by two researchers to include studies reported oncological safety. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were combined using random-effect model. Subgroup analyses were stratified by characteristics of disease, publication, study design and treatment center. Sixty-one studies with 63,369 patients (MIS 26956 and ARH 36,049) were included. The overall-analysis revealed a higher risk of recurrence (HR 1.209; 95% CI 1.102–1.327) and death (HR 1.124; 95% CI 1.013–1.248) after MIS versus ARH expect in FIGO IB1 (FIGO 2009 staging) patients with tumor size less than 2 cm. However, subgroup analyses showed comparable PFS/DFS and OS in studies published before the Laparoscopic Approach to Cervical Cancer (LACC) trial, published in European journals, conducted in a single center, performed in centers in Europe and in centers with high sample volume or high MIS sample volume. Our findings highlight possible factors that associated with inferior survival after MIS in cervical cancer including publication characteristics, center-geography and sample volume. Center associated factors were needed to be taken into consideration when evaluating complex surgical procedures like radical hysterectomy. The online version contains supplementary material available at 10.1007/s00404-021-06348-5.
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影响因子：
2.5
作者：
Yuce TK;Ellis RJ;Chung J;Merkow RP;Yang AD;Soper NJ;Tanner EJ;Schaeffer EM;Bilimoria KY;Auffenberg GB
通讯作者：
Auffenberg GB
影响因子：
4.8
作者：
He, Junshen;Hao, Min;Chen, Chunlin
通讯作者：
Chen, Chunlin
影响因子：
4.7
作者：
Brandt, Benny;Sioulas, Vasileios;Leitao, Mario M., Jr.
通讯作者：
Leitao, Mario M., Jr.
影响因子：
2.6
作者：
Gennari, Paolo;Gerken, Michael;Ignatov, Atanas
通讯作者：
Ignatov, Atanas
DOI：
10.3760/cma.j.issn.0253-3766.2017.06.011
发表时间：
2017-06-23
期刊：
Zhonghua zhong liu za zhi [Chinese journal of oncology]
影响因子：
--
作者：
He, H Y;Yang, Z J;Li, L
通讯作者：
Li, L