Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Surg Oncol. 2014 Sep;110(3):252-7. doi: 10.1002/jso.23631. Epub 2014 May 26.
To evaluate the long-term outcomes and risk factors for recurrence after fertility-sparing laparoscopic radical trachelectomy (LRT) in young women with early-stage cervical cancer.
Eighty-eight consecutive patients from four tertiary cancer centers in Korea who had attempted fertility-sparing LRT for early-stage cervical cancer were included in this study.
Seventy-nine patients completed LRT. The mean age and tumor size were 31 years (range, 20-40 years) and 1.8 cm (range, 0.4-7 cm), respectively. Twenty-nine patients had a tumor size greater than 2 cm, 22 had deep stromal invasion greater than 50%, and twelve had lymphovascular space invasion. After a median follow-up time of 44 months (range, 3-105 months), nine patients had recurrence and one had died of disease. A tumor size greater than 2 cm (P = 0.039) and a depth of stromal invasion greater than 50% (P = 0.016) were significant risk factors for recurrence.
This is the largest series on fertility-sparing LRT in young women with early cervical cancer. LRT is a feasible and safe fertility-sparing alternative to radical hysterectomy in these women. A tumor size greater than 2 cm and a depth of stromal invasion greater than 50% were risk factors for recurrence.
评估年轻宫颈癌患者行保留生育功能腹腔镜根治性宫颈切除术（LRT）后的长期结局和复发风险因素。
本研究纳入了韩国四家三级癌症中心的 88 例连续接受保留生育功能腹腔镜根治性宫颈切除术治疗早期宫颈癌的患者。
79 例患者完成了 LRT。平均年龄和肿瘤大小分别为 31 岁（范围，20-40 岁）和 1.8cm（范围，0.4-7cm）。29 例患者肿瘤大小大于 2cm，22 例患者深层间质浸润大于 50%，12 例患者淋巴管血管间隙浸润。中位随访时间为 44 个月（范围，3-105 个月）后，9 例患者复发，1 例患者死于疾病。肿瘤大小大于 2cm（P=0.039）和深层间质浸润大于 50%（P=0.016）是复发的显著风险因素。
这是关于年轻宫颈癌患者行保留生育功能腹腔镜根治性宫颈切除术的最大系列研究。对于这些患者，LRT 是根治性子宫切除术的一种可行且安全的保留生育功能替代方法。肿瘤大小大于 2cm 和深层间质浸润大于 50%是复发的风险因素。
