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广泛性子宫切除术治疗早期宫颈癌:LACC 试验后我们该怎么做?

Radical hysterectomy for early cervical cancer: what shall we do after the LACC trial?

机构信息

Department of Obstetrics and Gynaecology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

出版信息

Arch Gynecol Obstet. 2020 Aug;302(2):289-292. doi: 10.1007/s00404-020-05627-x.

Abstract

Surgical treatment of cervical cancer has led to one of the greatest controversies in gynecological oncology in recent years. After laparoscopic radical hysterectomy became increasingly widespread worldwide, it lost its importance dramatically when the data from the LACC study were published. In contrast to previous assumptions, there was a significantly reduced survival after laparoscopic hysterectomy compared to the open abdominal procedure. Multiple studies were subsequently published. Some confirm these results some do not. Some consider further studies to be unethical, others point to their own non-randomized results and call for a new LACC study. This article gives an overview of the current data situation and the possible criticisms of the individual studies. And, finally, calls for new RCT's under defined criteria.

摘要

宫颈癌的外科治疗近年来引发了妇科肿瘤学领域最大的争议之一。在腹腔镜根治性子宫切除术在全球范围内日益普及后,LACC 研究的数据公布后,其重要性显著降低。与之前的假设相反,与开腹手术相比,腹腔镜子宫切除术的生存率显著降低。随后发表了多项研究。一些研究证实了这些结果,而另一些则没有。一些研究认为进一步的研究不道德,另一些则指出自己的非随机结果,并呼吁开展新的 LACC 研究。本文概述了当前的数据情况和对个别研究的可能批评,并最终呼吁根据明确标准开展新的 RCT。

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