Lifehouse Gynaecological Oncology Group, Chris O'Brien Lifehouse, Sydney, NSW, Australia.
Central clinical school, The University of Sydney, Sydney, NSW, Australia.
Aust N Z J Obstet Gynaecol. 2021 Feb;61(1):123-127. doi: 10.1111/ajo.13219. Epub 2020 Jul 27.
The Laparoscopic Approach to Cervical Cancer (LACC) trial is the first phase III randomised, multicentred trial to compare oncologic outcomes associated with open radical hysterectomy vs minimally invasive surgery (MIS) for treatment of early cervical cancer.
To evaluate our surgical experience in patients with early cervical cancer.
The Lifehouse Gynaecologic Oncology database was queried based upon the eligibility criteria of the LACC study and included all FIGO 2009 stage (1A1 with lymph vascular space invasion, 1A2, 1B1) cervical cancer women from 2008-2018. Patients were also included in our study if they had abdominal radical trachelectomy (ART), laparoscopic radical hysterectomy (TLRH) and robotic radical trachelectomy (RRT).
Forty-six women were identified with four exclusions. Thirty-seven women had stage 1B1 disease, 24 had a squamous cell carcinoma, 15 had an adenocarcinoma and three had an adenosquamous carcinoma of the cervix. Of the 42 eligible patients, 32 underwent an open abdominal approach (26 total abdominal radical hysterectomy (TARH), six ART) and ten a MIS approach (nine TLRH and one RRT) with a mean follow-up of 4.8 years. All 42 women had a pelvic lymph node dissection, eight women had nodal metastases and 16 patients received adjuvant chemoradiation. Two of the nine women in the laparoscopic radical hysterectomy group had a recurrence. Both had adenocarcinoma, stage 1B1 disease. There were no recurrences in the TARH group or radical trachelectomy groups.
Our data, albeit limited in number, have reflected the results of the LACC trial that MIS was associated with a lower disease-free survival than open radical hysterectomy.
腹腔镜治疗宫颈癌（LACC）试验是首个比较开放根治性子宫切除术与微创外科（MIS）治疗早期宫颈癌相关肿瘤学结果的 III 期随机、多中心试验。
评估我们在早期宫颈癌患者中的手术经验。
根据 LACC 研究的入选标准，Lifehouse 妇科肿瘤学数据库进行了查询，包括 2008 年至 2018 年所有国际妇产科联盟（FIGO）2009 分期（1A1 伴淋巴血管间隙浸润、1A2、1B1）宫颈癌女性。如果患者接受了腹式根治性宫颈切除术（ART）、腹腔镜根治性子宫切除术（TLRH）和机器人根治性宫颈切除术（RRT），我们的研究也包括这些患者。
共确定了 46 名女性，但有 4 名被排除。37 名女性患有 1B1 期疾病，24 名患有鳞状细胞癌，15 名患有腺癌，3 名患有宫颈腺鳞癌。在 42 名符合条件的患者中，32 名接受了开放式腹部手术（26 名接受了全腹部根治性子宫切除术（TARH），6 名接受了 ART），10 名接受了 MIS 手术（9 名 TLRH，1 名 RRT），平均随访时间为 4.8 年。所有 42 名女性均接受了盆腔淋巴结清扫术，8 名女性有淋巴结转移，16 名患者接受了辅助放化疗。腹腔镜根治性子宫切除术组的 2 名女性出现复发。两者均为腺癌，1B1 期疾病。TARH 组或根治性宫颈切除术组均无复发。
我们的数据数量有限，但反映了 LACC 试验的结果，即 MIS 与开放根治性子宫切除术相比，疾病无进展生存率较低。
