Gynecologic Oncology Department, Maria Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland.
Int J Gynecol Cancer. 2009 Nov;19(8):1390-5. doi: 10.1111/IGC.0b013e3181ba5e88.
The goal of this retrospective analysis was to compare the results of treatment in patients with early cervical cancer managed by laparoscopy with those for patients observed after laparotomy.
The retrospective analysis was carried out with 22 patients operated on with total laparoscopic hysterectomy and 58 patients treated by abdominal hysterectomy. Patients with clinical tumor stage IA, IB1, or IIA were eligible for surgery. The main efficacy end point was disease-free survival evaluated by the Kaplan-Meier method. The survival curves were compared using log-rank tests. In addition, length of hospitalization, duration of surgery, and complication rate were compared. P < 0.05 was set as statistically significant.
Predicted 3-year disease-free survival rates in the "open surgery" and "laparoscopy" groups were 0.86 (standard deviation [SD], 0.049) and 0.82 (SD, 0.098), respectively (P = 0.53). Recurrence rate was 13.6% after laparoscopy and 12% in open surgery. In 2 patients, intraperitoneal spread occurred after laparoscopy. The operation time was longer and hospitalization shorter after laparoscopy.
The 3-year disease-free survival was similar in both groups. Total laparoscopic radical hysterectomy may be an option in early cervical cancer; however, the intraperitoneal spread in 2 patients compels a search for possible risk factors in patients managed by laparoscopy.
本回顾性分析旨在比较腹腔镜治疗早期宫颈癌患者与开腹手术治疗患者的结果。
本回顾性分析纳入了 22 例行全腹腔镜子宫切除术的患者和 58 例行腹式子宫切除术的患者。临床肿瘤分期为 IA、IB1 或 IIA 的患者有手术适应证。主要疗效终点是通过 Kaplan-Meier 法评估无病生存率。使用对数秩检验比较生存曲线。此外，还比较了住院时间、手术时间和并发症发生率。P<0.05 为统计学显著。
“开腹手术”和“腹腔镜”组的 3 年无病生存率预测值分别为 0.86（标准差[SD]，0.049）和 0.82（SD，0.098）（P=0.53）。腹腔镜组的复发率为 13.6%，开腹组为 12%。腹腔镜组有 2 例发生腹腔内播散。腹腔镜组的手术时间较长，住院时间较短。
两组的 3 年无病生存率相似。全腹腔镜根治性子宫切除术可能是早期宫颈癌的一种选择；然而，腹腔镜组的 2 例患者发生腹腔内播散，需要寻找可能的腹腔镜治疗患者的危险因素。
