Toptas Tayfun, Simsek Tayup
Division of Gynecologic Oncological Surgery, Department of Obstetrics and Gynecology, Akdeniz University Hospital , Antalya, Turkey .
J Laparoendosc Adv Surg Tech A. 2014 Jun;24(6):373-8. doi: 10.1089/lap.2013.0514. Epub 2014 Apr 17.
Few reports have examined the impact of laparoscopic approach on survival outcomes in patients with early-stage (IA2-IB1) cervical cancer (CC). In this study we aimed to compare disease recurrence and survival outcomes of total laparoscopic radical hysterectomy (TLRH) with those for open radical hysterectomy (ORH) and pelvic lymphadenectomy in patients with early-stage CC.
A single-center, retrospective analysis was conducted in a total of 68 patients who treated with TLRH (n=22) or ORH (n=46) between 2007 and 2010. The primary endpoint of the study was progression-free survival (PFS).
Median follow-up time was 42.50 months (range, 38.40-55.42 months) for the TLRH group and 43.50 months (range, 37.66-52.65) for the ORH group. The study groups were comparable in terms of baseline characteristics except the ORH group had more patients with tumor size greater than 2 cm (P=.026), depth of stromal invasion greater than 33% (P<.0001), and International Federation of Gynecology and Obstetrics stage IB1 disease (P=.019). However, these factors had no impact on overall and PFS in Cox regression analyses. In total, three recurrences were observed in the TLRH group. Two of the 3 patients were alive with no evidence of disease, and the remaining individual was alive with disease (AWD). In the ORH group, 5 patients had recurrences. Two of the 5 patients died of disease, and three were AWD. The estimated 3-year PFS (86.1% versus 90.6%, respectively; P=.32) and overall survival (100% vs. 95.4%, respectively; P=.82) were comparable in the TLRH and ORH groups.
TLRH and ORH have similar survival outcomes in patients with early-stage CC.
很少有报告研究腹腔镜手术方法对早期（IA2 - IB1期）宫颈癌（CC）患者生存结局的影响。在本研究中，我们旨在比较早期CC患者全腹腔镜根治性子宫切除术（TLRH）与开放性根治性子宫切除术（ORH）及盆腔淋巴结清扫术的疾病复发和生存结局。
对2007年至2010年间接受TLRH（n = 22）或ORH（n = 46）治疗的68例患者进行单中心回顾性分析。该研究的主要终点是无进展生存期（PFS）。
TLRH组的中位随访时间为42.50个月（范围38.40 - 55.42个月），ORH组为43.50个月（范围37.66 - 52.65个月）。除ORH组有更多肿瘤大小大于2 cm的患者（P = 0.026）、基质浸润深度大于33%的患者（P < 0.0001）以及国际妇产科联盟IB1期疾病患者（P = 0.019）外，研究组在基线特征方面具有可比性。然而，在Cox回归分析中，这些因素对总生存期和PFS均无影响。TLRH组共观察到3例复发。3例患者中有2例存活且无疾病证据，其余1例带瘤存活（AWD）。ORH组有5例复发。5例患者中有2例死于疾病，3例AWD。TLRH组和ORH组的估计3年PFS（分别为86.1%和90.6%；P = 0.32）和总生存期（分别为100%和95.4%；P = 0.82）具有可比性。
TLRH和ORH在早期CC患者中具有相似的生存结局。
