Hu Ting Wen Yi, Ming Xiu, Yan Hao Zheng, Li Zheng Yu
Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Cancer Manag Res. 2019 Sep 9;11:8249-8255. doi: 10.2147/CMAR.S216929. eCollection 2019.
The study aimed to explore the survival outcomes of early-stage cervical cancer (CC) patients treated with laparoscopic/abdominal radical hysterectomy (LRH/ARH).
We performed a retrospective analysis involving women who had undergone LRH/ARH for CC in early stage during the 2013-2015 period in West China Second University Hospital. The survival outcomes and potential prognostic factors were evaluated using Kaplan-Meier method and Cox regression analysis, respectively.
A total of 678 patients were included in our analysis. The overall survival (OS) and progression-free survival (PFS) between the ARH (n=423) and LRH (n=255) groups achieved no significant differences (=0.122, 0.285, respectively). However, in patients with a tumor diameter >4 cm, the OS of the LRH group was significantly shorter than that of the ARH group (=0.017). Conversely, in patients with a tumor diameter ≤4 cm, the LRH group had a significantly longer OS than the ARH group (=0.013). The multivariate Cox analysis revealed that International Federation of Gynecology and Obstetrics stage, histology, parametrial invasion, and pelvic lymph node invasion were independent prognostic factors for OS and PFS, whereas surgical method was not a statistically significant predictor of OS (=0.806) or PFS (=0.236) in CC patients.
LRH was an alternative to ARH for surgical treatment of CC patients with a tumor diameter ≤4 cm. However, for the patients with a tumor diameter >4 cm, priority should be given to ARH.
本研究旨在探讨接受腹腔镜/腹式根治性子宫切除术（LRH/ARH）治疗的早期宫颈癌（CC）患者的生存结局。
我们对2013年至2015年期间在华西第二医院接受早期CC的LRH/ARH手术的女性进行了回顾性分析。分别采用Kaplan-Meier法和Cox回归分析评估生存结局和潜在的预后因素。
我们的分析共纳入678例患者。ARH组（n = 423）和LRH组（n = 255）之间的总生存期（OS）和无进展生存期（PFS）无显著差异（分别为= 0.122，0.285）。然而，在肿瘤直径> 4 cm的患者中，LRH组的OS明显短于ARH组（= 0.017）。相反，在肿瘤直径≤4 cm的患者中，LRH组的OS明显长于ARH组（= 0.013）。多因素Cox分析显示，国际妇产科联盟分期、组织学、宫旁浸润和盆腔淋巴结浸润是OS和PFS的独立预后因素，而手术方式在CC患者中不是OS（= 0.806）或PFS（= 0.236）的统计学显著预测因素。
对于肿瘤直径≤4 cm的CC患者，LRH是ARH手术治疗的替代方法。然而，对于肿瘤直径> 4 cm的患者，应优先选择ARH。
