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腹腔镜分期手术治疗子宫内膜癌的长期生存结果:20年随访

Long-term survival outcomes of laparoscopic staging surgery in treating endometrial cancer: 20 years of follow-up.

作者信息

Lee Chyi-Long, Kusunoki Soshi, Huang Kuan-Gen, Wu Kai-Yun, Huang Chen-Yin, Yen Chih-Feng

机构信息

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan.

Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, Hongo, Bunkyo-ku, Japan.

出版信息

Taiwan J Obstet Gynecol. 2016 Aug;55(4):545-51. doi: 10.1016/j.tjog.2016.04.035.

Abstract

OBJECTIVE

To assess the long-term outcomes of laparoscopic staging surgery (LSS) in treating patients with endometrial carcinoma.

MATERIALS AND METHODS

Patients with endometrial cancer who underwent LSS between June 1995 and June 2014 were prospectively registered. Perioperative data, complications, disease recurrence, and long-term survival were measured.

RESULTS

The study included 287 consecutive patients [mean age (± standard deviation), 53±10.4 years; mean body mass index, 27.3±6.7 kg/m(2)] with a median follow-up ranging from 1 to 216 months. No laparotomy conversion was recorded for any patient. The mean operative time was 207±63.5 minutes, and the mean blood loss was 183±166.7 mL. The mean numbers of pelvic nodes and para-aortic nodes removed were 18±4.8 and 8±5, respectively. More than 80% of the patients had an International Federation of Gynecology and Obstetrics (FIGO) Stage 1 disease. The overall complication rate was 3.1%, including two patients of bladder injuries and one with bowel injury intraoperatively, and postoperatively one patient with pelvic abscess, three with urinary tract infection, one with voiding difficulty, and one with bowel perforation. The overall survival rates were 94% in 5 years and 92.7% in 20 years. No port-site metastasis was recorded in this study.

CONCLUSIONS

Patients with endometrial carcinoma treated by LSS had compatible or even better long-term survival outcomes and less complication in comparison with the published data, in addition to the benefits of its minimally invasive characteristics. LSS should be the treatment of choice for endometrial cancer.

摘要

目的

评估腹腔镜分期手术(LSS)治疗子宫内膜癌患者的长期疗效。

材料与方法

对1995年6月至2014年6月期间接受LSS的子宫内膜癌患者进行前瞻性登记。测量围手术期数据、并发症、疾病复发和长期生存率。

结果

该研究纳入了287例连续患者[平均年龄(±标准差),53±10.4岁;平均体重指数,27.3±6.7kg/m²],中位随访时间为1至216个月。所有患者均未记录中转开腹情况。平均手术时间为207±63.5分钟,平均失血量为183±166.7mL。切除的盆腔淋巴结和腹主动脉旁淋巴结的平均数量分别为18±4.8个和8±5个。超过80%的患者为国际妇产科联盟(FIGO)1期疾病。总体并发症发生率为3.1%,包括术中2例膀胱损伤、1例肠损伤,术后1例盆腔脓肿、3例尿路感染、1例排尿困难和1例肠穿孔。5年总生存率为94%,20年总生存率为92.7%。本研究未记录切口部位转移。

结论

与已发表的数据相比,接受LSS治疗的子宫内膜癌患者具有相当甚至更好的长期生存结果,并发症更少,此外还具有微创特性的优势。LSS应成为子宫内膜癌的首选治疗方法。

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