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腹腔镜与开腹根治性子宫切除术治疗早期宫颈癌的生存比较:一项随机对照试验。

Survival after Laparoscopic versus Abdominal Radical Hysterectomy in Early Cervical Cancer: A Randomized Controlled Trial.

机构信息

Instituto de Saúde Pública da Universidade do Porto, Universidade do Porto, Portugal.

Serviço de Ginecologia, Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil.

出版信息

Asian Pac J Cancer Prev. 2021 Jan 1;22(1):93-97. doi: 10.31557/APJCP.2021.22.1.93.

Abstract

BACKGROUND

Previous studies have reported the safety of laparoscopic radical hysterectomy for treatment of early cervical cancer, as option to laparotomy. This study aims to compare overall survival between laparoscopic versus abdominal radical hysterectomy for early cervical cancer.

METHODS

A single-center randomized controlled trial enrolled 30 patients with clinically staged IA2 cervical cancer and lymphovascular invasion, IB and IIA, who underwent laparoscopic radical hysterectomy (16) or abdominal radical hysterectomy (14).

RESULT

The mean overall survival time was 74.74 months (CI 95%: 54.15-95.33) for LRH 91.67 months (CI 95%: 74.97-108.37) for ARH (log-rank test = 0.30). The mean disease-free survival time was 81.07 months (CI 95%: 60.95-101.19) for LRH and 95.82 months (CI 95%: 80.18-111.47) for ARH (log-rank test = 0.371). The overall survival hazard ratio was 2.05 (CI 95%: 0.51-8.24), and the disease-free hazard ratio was 2.13 (CI 95%: 0.39-11.7).

CONCLUSION

Our study suggests a non-significant trend of worse outcomes for LRH. In light of recent controversy and need for prospective studies, further studies in different populations are required for definite conclusions and until then, patients should be aware of risks and benefits, survival data and quality of life outcomes related to both surgical techniques.

摘要

背景

先前的研究报告了腹腔镜根治性子宫切除术治疗早期宫颈癌的安全性,可作为剖腹手术的替代方案。本研究旨在比较腹腔镜与剖腹根治性子宫切除术治疗早期宫颈癌的总生存率。

方法

一项单中心随机对照试验纳入了 30 例临床分期为 IA2 期宫颈癌且有淋巴血管侵犯、IB 期和 IIA 期的患者,行腹腔镜根治性子宫切除术(16 例)或剖腹根治性子宫切除术(14 例)。

结果

LRH 的平均总生存时间为 74.74 个月(95%CI:54.15-95.33),ARH 为 91.67 个月(95%CI:74.97-108.37)(对数秩检验=0.30)。LRH 的平均无病生存时间为 81.07 个月(95%CI:60.95-101.19),ARH 为 95.82 个月(95%CI:80.18-111.47)(对数秩检验=0.371)。总生存风险比为 2.05(95%CI:0.51-8.24),无病生存风险比为 2.13(95%CI:0.39-11.7)。

结论

我们的研究表明 LRH 的结果存在非显著的恶化趋势。鉴于最近的争议和对前瞻性研究的需求,需要在不同人群中进行进一步的研究,以得出明确的结论,在此之前,患者应了解两种手术技术相关的风险、获益、生存数据和生活质量结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/caa7/8184196/adcccba8ad47/APJCP-22-093-g001.jpg

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