Januszek Sławomir M, Wita-Popow Barbara, Kluz Marta, Janowska Magdalena, Januszek Rafał, Wróbel Andrzej, Rogowski Artur, Malinowski Krzysztof P, Zuzak Tomasz, Kluz Tomasz
Department of Gynecology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland.
Department of Pathology, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland.
J Clin Med. 2021 Jan 22;10(3):429. doi: 10.3390/jcm10030429.
Surgical treatment is the most important part of therapy for endometrial cancer. The aim of the study was to define factors having the most significant impact on surgical treatment of endometrial cancer when using traditional and laparoscopic methods. In the study, we evaluated 75 females who were treated for endometrial cancer via laparoscopic surgery in 2019 and used a historical control of 70 patients treated by laparotomy in 2011. The evaluated risk factors included the method of surgery, type of lymphadenectomy, patient's age, various obesity parameters, histological grading, cancer clinical staging, pelvic dimensions, previous abdominal surgeries, comorbidities, and number of deliveries. The duration of hospitalization, operation time, loss of hemoglobin, and procedure-related complications were used as parameters of perioperative outcomes. Multivariable linear regression analysis confirmed the following factors as being predictors of worse perioperative outcomes: laparotomy, abdominal obesity (waist circumstance and waist-to-hip ratio), range of lymphadenectomy, prior abdominal surgeries, and larger pelvic dimensions. Abdominal obesity is a significant risk factor in the treatment of endometrial cancer. Laparotomy continues to be utilized frequently in the management of endometrial cancer in Poland as well as elsewhere, and adopting a minimally invasive approach is likely to be beneficial for patient outcome.
手术治疗是子宫内膜癌治疗的最重要部分。本研究的目的是确定在使用传统方法和腹腔镜方法时，对子宫内膜癌手术治疗影响最显著的因素。在该研究中，我们评估了2019年通过腹腔镜手术治疗子宫内膜癌的75名女性，并采用了2011年接受剖腹手术的70名患者作为历史对照。评估的风险因素包括手术方式、淋巴结清扫类型、患者年龄、各种肥胖参数、组织学分级、癌症临床分期、盆腔尺寸、既往腹部手术史、合并症和分娩次数。住院时间、手术时间、血红蛋白丢失和与手术相关的并发症被用作围手术期结局的参数。多变量线性回归分析证实以下因素是围手术期结局较差的预测因素：剖腹手术、腹部肥胖（腰围和腰臀比）、淋巴结清扫范围、既往腹部手术史和较大的盆腔尺寸。腹部肥胖是子宫内膜癌治疗中的一个重要危险因素。在波兰以及其他地方，剖腹手术在子宫内膜癌的治疗中仍经常被使用，采用微创方法可能对患者的预后有益。
