Laparoscopic Radical Hysterectomy and Pelvic Lymphadenectomy Can Be Routinely Used for Treatment of Early-stage Cervical Cancer: A Single-institute Experience With 404 Patients
Laparoscopic Radical Hysterectomy and Pelvic Lymphadenectomy Can Be Routinely Used for Treatment of Early-stage Cervical Cancer: A Single-institute Experience With 404 Patients
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DOI：
10.1016/j.jmig.2014.09.009
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发表时间：
2015-02-01
影响因子：
4.1
通讯作者：
Wang, Zehua
中科院分区：
文献类型：
--
作者：
Yang, Lu;Cai, Jing;Wang, Zehua
研究目的：我们研究的目的是确定腹腔镜根治性子宫切除术（LRH）是否可以常规用于治疗早期宫颈cancer.Design：从2008年5月，LRH计划为所有主要可手术的宫颈癌患者在我们部门接受知情同意后。回顾性评价手术和肿瘤学结果（加拿大工作组分类III）。设置：大学教学医院。患者和干预措施：到2013年8月，404例浸润性宫颈癌患者被认为是可手术的，所有患者都接受了前期LRH，除了1例坚持开放手术的患者。测量和主要结果：3例患者因无法手术而放弃计划的LRH。中位手术时间为240分钟（范围：100-410分钟）。中位失血量为300 mL（范围：50-800 mL）。获得的盆腔淋巴结的中位数为23.5（范围，11-54）。2例患者手术切缘阳性。7例患者发生术中并发症，2例患者必须转为开放手术（转换率= 0.5%）。术后发生尿路瘘3例。69例患者接受了辅助治疗。中位随访时间为31个月（范围：7-69个月）。30例患者出现复发性疾病，中位无病间隔为12个月（范围，6-23个月），24例死于疾病。估计3年总生存率为94.9%的妇女与肿瘤IB 1，和3年无进展生存率分别为94.1%和79.6%，respectively.Conclusion：LRH是足够的，安全的，可行的妇女与宫颈癌，它可以作为一种主要的方式常规用于治疗早期肿瘤。(C)2015年AAGL。All rights reserved.
Study Objective: The aim of our study was to determine if laparoscopic radical hysterectomy (LRH) can be routinely used for the treatment of early-stage cervical cancer.Design: From May 2008, LRH was planned for all primarily operable cervical cancer patients after receiving informed consent in our department. The surgical and oncologic outcomes were retrospectively evaluated (Canadian Task Force classification III).Setting: University teaching hospital.Patients and Interventions: By August 2013, 404 patients with invasive cervical cancer were deemed operable, and all of them were subjected to upfront LRH, except 1 patient who insisted on open surgery.Measurements and Main Results: The planned LRH was abandoned in 3 patients because of inoperability. The median operative time was 240 minutes (range, 100-410 minutes). The median blood loss was 300 mL (range, 50-800 mL). The median number of harvested pelvic lymph nodes was 23.5 (range, 11-54). Two patients had positive surgical margins. Intraoperative complications occurred in 7 of the patients, and a conversion to open surgery was mandatory for 2 patients (conversion rate = 0.5%). Postoperative urinary tract fistula developed in 3 patients. Sixty-nine patients underwent adjuvant therapy. The median duration of follow-up was 31 months (range, 7-69 months). Thirty patients developed recurrent disease with a median disease-free interval of 12 months (range, 6-23 months), and 24 died of disease. The estimated 3-year overall survival rate was 94.9% in the women with a tumor IB1, and the 3-year progression-free survival rates were 94.1% and 79.6%, respectively.Conclusion: LRH is adequate, safe, and feasible for women with cervical cancer, and it can be routinely used for the treatment of early-stage tumors as a primary modality. (C) 2015 AAGL. All rights reserved.