Comparison of laparoscopic and abdominal radical hysterectomy for early stage cervical cancer: oncologic outcomes based on tumor diameter
Comparison of laparoscopic and abdominal radical hysterectomy for early stage cervical cancer: oncologic outcomes based on tumor diameter
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DOI：
10.1136/ijgc-2020-001504
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发表时间：
2020-09-01
影响因子：
4.8
通讯作者：
Chen, Chunlin
中科院分区：
文献类型：
--
作者：
He, Junshen;Hao, Min;Chen, Chunlin
背景早期宫颈癌在中国中很常见，在发展中国家仍然是一个主要的公共卫生负担。我们的目标是确定早期宫颈癌患者在腹腔镜术和开腹根治性子宫切除术之间的长期肿瘤学结果。方法对37家医院进行多中心、回顾性、病例对照研究。纳入2004年1月至2016年12月连续行腹腔镜或开腹根治性子宫切除术的早期宫颈癌患者，其临床分期符合国际妇产科联合会(FIGO)2009年IA1分期，并伴有IB1淋巴血管侵犯。我们基于预后相关因素，在1：1病例对照配对设置中比较了两种方法的无病生存率和总生存率。结果在46 313例患者中，我们选择了8470例。配对后发现，腹腔镜手术与5年无瘤生存率显著相关(89.5%vs 93.1%，p=0.001；风险比(HR)1.6，p=0.001)，但与5年总生存率(94.3%vs 96.0%，HR=1.48，p=0.058)无关。在亚组分析中，在肿瘤直径为
Background Early stage cervical cancer is prevalent in China and remains a major public health burden in developing countries. We aimed to determine the long term oncologic outcomes between laparoscopic and abdominal radical hysterectomy in patients with early cervical cancer. Methods We conducted a multicenter, retrospective, case-control study of 37 hospitals. All consecutive early stage cervical cancer patients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA1 with lymphovascular space invasion to IB1, who underwent laparoscopic or abdominal radical hysterectomy between January 2004 and December 2016, were included. We compared the disease free survival and overall survival of the two approaches in 1:1 case-control matched settings based on prognosis related factors. Results We selected 8470 of 46 313 patients. After matching (n=1601/1601), we found that laparoscopic surgery was associated with significantly worse 5 year disease free survival (89.5% vs 93.1%, p=0.001; hazard ratio (HR) 1.60, p=0.001), but not 5 year overall survival (94.3% vs 96.0%, HR=1.48, p=0.058). In the subgroup analysis, in patients with a tumor diameter