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腹腔镜与腹式根治性子宫切除术治疗早期宫颈癌的生存结局比较:一项法国多中心研究。

Comparison of survival outcomes between laparoscopic and abdominal radical hysterectomy for early-stage cervical cancer: A French multicentric study.

机构信息

Department of Gynecology and Obstetrics, Tenon University Hospital (AP-HP), Sorbonne University, Institut Universitaire de Cancérologie (IUC), France.

Lyon 1 University, Department of Gynecological and Oncological Surgery, Obstetrics, University Hospital Lyon Sud, 69495, Pierre Bénite, France.

出版信息

J Gynecol Obstet Hum Reprod. 2021 Feb;50(2):102046. doi: 10.1016/j.jogoh.2020.102046. Epub 2020 Dec 16.

Abstract

OBJECTIVES

A recent randomized controlled trial has reconsidered the use of laparoscopy for treating patients with early-stage cervical cancer with radical hysterectomy (RH). We aimed to evaluate if surgical approach had an impact on surgical and oncological outcomes in these patients in a French setting.

METHODS

Data of 1706 patients with cervical cancer treated between 1996 and 2017 were extracted from maintained databases of 9 French University hospitals. Patients, with FIGO stage IA2 to IIB tumors, treated by radical hysterectomy were selected for further analysis. A propensity score matching was used with a ratio of 2:1 in favor of laparoscopic approach was used. The Kaplan Meier method was used to estimate the survival distribution.

RESULTS

34 patients treated with laparotomy were matched with 61 patients treated by minimally invasive surgery (MIS). There was no difference regarding overall survival (91 % vs 81 %, p > 0.05) or disease-free survival (82 % vs 78 %, p > 0.05). There was no difference regarding surgical outcomes with no excess of postoperative complication in patients with MIS. Hospital stay was significantly longer in patients operated on laparotomy.

CONCLUSION

In our study, there was no evidence of a difference in survival between minimally invasive surgery and laparotomy in patients treated with radical hysterectomy for early-stage cervical cancer.

摘要

目的

最近一项随机对照试验重新考虑了在根治性子宫切除术(RH)中应用腹腔镜治疗早期宫颈癌患者的问题。我们旨在评估在法国环境下,手术方法是否会对这些患者的手术和肿瘤学结果产生影响。

方法

从 9 所法国大学医院的维护数据库中提取了 1996 年至 2017 年间治疗的 1706 例宫颈癌患者的数据。选择 FIGO 分期为 IA2 至 IIB 期肿瘤、接受根治性子宫切除术的患者进行进一步分析。使用倾向评分匹配,腹腔镜方法的优势比为 2:1。采用 Kaplan-Meier 方法估计生存分布。

结果

34 例接受剖腹手术的患者与 61 例接受微创手术(MIS)的患者相匹配。总生存率(91% vs 81%,p>0.05)或无病生存率(82% vs 78%,p>0.05)无差异。微创手术患者术后并发症无增加,手术结果无差异。剖腹手术患者的住院时间明显延长。

结论

在我们的研究中,对于接受根治性子宫切除术治疗的早期宫颈癌患者,微创手术与剖腹手术之间在生存率方面没有证据表明存在差异。

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