School of Medicine and Life Sciences (Drs. Guo and X. Chen), and the Department of Gynecologic Oncology (Drs. Zhang, Sun and Sheng), Shandong Cancer Hospital and Institute, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China(Drs. Guo, Zhang, X.Chen, Sun and Sheng), and the Department of Cardiothoracic Surgery, The 2nd Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China (Dr. K. Chen).
School of Medicine and Life Sciences (Drs. Guo and X. Chen), and the Department of Gynecologic Oncology (Drs. Zhang, Sun and Sheng), Shandong Cancer Hospital and Institute, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China(Drs. Guo, Zhang, X.Chen, Sun and Sheng), and the Department of Cardiothoracic Surgery, The 2nd Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China (Dr. K. Chen)..
J Minim Invasive Gynecol. 2019 Mar-Apr;26(3):484-491. doi: 10.1016/j.jmig.2018.06.006. Epub 2018 Jun 13.
To compare the surgical and oncologic outcomes between abdominal radical trachelectomy (ART) and radical hysterectomy (RH) for stage IA2-IB1 cervical cancer.
A retrospective cohort study (Canadian Task Force classification II-2).
Shandong Cancer Hospital, Shandong, China.
Three hundred twenty-nine patients with IA2-IB1 cervical cancer.
All patients underwent ART or RH.
All patients were divided into ART (n = 143) and RH (n = 186) groups according to the surgical approach. Additionally, oncologic and fertility outcomes were compared for different tumor pathologies and sizes in ART patients. The ART group had similar case characteristics as the RH group, except that the ART group had a longer surgical time. During a similar follow-up period, there were 4 (2.9%) recurrences and 3 (2.2%) patients who died from recurrence in the ART group compared with 8 (4.6%) recurrences and 4 (2.3%) patients who died from recurrence in the RH group (p = .444 and p = .999, respectively). In the ART group, squamous cell carcinoma (SCC) patients had a 5-year overall survival and pregnancy rate similar to those of non-SCC patients (98.1% vs 96.8%, p = .999; 33.3% vs 26.7%, p = .873), and patients with tumors ≤2 cm and 2 to 4 cm experienced a similar 5-year overall survival rate (97.0% vs 98.6%, p = .999), except patients with tumors ≤2 cm had a higher pregnancy rate (45.2% vs 17.2%, p = .020).
ART seems to have similar surgical and oncologic outcomes to RH, except ART has a longer surgical time. Both non-SCC patients and stage IA2-IB1 patients with 2- to 4-cm tumors can undergo ART safely. Patients with tumors ≤2 cm have a higher pregnancy rate than patients with 2- to 4-cm tumors.
比较腹式根治性子宫颈切除术（ART）和根治性子宫切除术（RH）治疗 IA2-IB1 期宫颈癌的手术和肿瘤学结果。
回顾性队列研究（加拿大任务组分类 II-2）。
中国山东肿瘤医院。
329 例 IA2-IB1 期宫颈癌患者。
所有患者均行 ART 或 RH。
根据手术方式，所有患者分为 ART（n=143）和 RH（n=186）组。此外，还比较了 ART 患者不同肿瘤病理和大小的肿瘤学和生育结局。ART 组与 RH 组的病例特征相似，除了 ART 组的手术时间较长。在相似的随访期间，ART 组有 4 例（2.9%）复发，3 例（2.2%）因复发而死亡，RH 组有 8 例（4.6%）复发，4 例（2.3%）因复发而死亡（p=0.444 和 p=0.999）。在 ART 组中，鳞状细胞癌（SCC）患者的 5 年总生存率和妊娠率与非 SCC 患者相似（98.1%比 96.8%，p=0.999；33.3%比 26.7%，p=0.873），肿瘤直径≤2 cm 和 2-4 cm 的患者 5 年总生存率相似（97.0%比 98.6%，p=0.999），但肿瘤直径≤2 cm 的患者妊娠率较高（45.2%比 17.2%，p=0.020）。
ART 的手术和肿瘤学结果似乎与 RH 相似，只是 ART 的手术时间较长。非 SCC 患者和 IA2-IB1 期肿瘤直径为 2-4 cm 的患者均可安全接受 ART。肿瘤直径≤2 cm 的患者妊娠率高于肿瘤直径为 2-4 cm 的患者。
