Department of Obstetrics and Gynecology, St. Vincent's hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Seoul St. Mary's hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Int J Med Sci. 2021 Jan 19;18(5):1312-1317. doi: 10.7150/ijms.55017. eCollection 2021.
The aim of this study was to compare survival outcomes of open radical hysterectomy and minimally invasive radical hysterectomy (MIS) in early stage cervical cancer.
A retrospective analysis of 148 patients with stage IB1 - IIA2 cervical cancer who underwent either minimally invasive or open radical hysterectomy. Tumor characteristics, recurrence rate, disease-free survival (DFS), and overall survival (OS) were compared according to surgical approach.
In total, 110 and 38 patients were assigned to open surgery and MIS groups. After a medical follow-up of 42.1 months, the groups showed similar survival outcomes (recurrence rate, DFS, and OS). However, in patients with tumor size >2 cm, recurrence rate was significantly higher in MIS group (22.5% vs 0%; p=0.008). And in patients with tumor size >2 cm, MIS group showed significantly poorer DFS than open surgery group (p=0.017), although OS was similar between the two groups (p=0.252).
In patients with tumor size >2 cm, MIS was associated with higher recurrence rates and poorer DFS than open surgery. However, in patients with tumor size ≤2 cm, MIS did not seem to compromise oncologic outcomes.
本研究旨在比较早期宫颈癌行开腹根治性子宫切除术和微创根治性子宫切除术（MIS）的生存结局。
回顾性分析 148 例接受微创或开腹根治性子宫切除术的 IB1 期- IIA2 期宫颈癌患者。根据手术方式比较肿瘤特征、复发率、无病生存率（DFS）和总生存率（OS）。
共有 110 例和 38 例患者分别被分配到开腹手术组和 MIS 组。经过 42.1 个月的医疗随访，两组的生存结局相似（复发率、DFS 和 OS）。然而，在肿瘤大小>2cm 的患者中，MIS 组的复发率显著更高（22.5% vs 0%；p=0.008）。在肿瘤大小>2cm 的患者中，MIS 组的 DFS 明显劣于开腹手术组（p=0.017），尽管两组的 OS 相似（p=0.252）。
对于肿瘤大小>2cm 的患者，MIS 与更高的复发率和较差的 DFS 相关，而对于肿瘤大小≤2cm 的患者，MIS 似乎不会影响肿瘤学结局。
