Department of Obstetrics and Gynecology, Skåne University Hospital, Lund University, SE-22185, Lund, Sweden.
Region Västra Götaland, Regional Cancer Centre West, SE-41345, Gothenburg, Sweden.
BMC Cancer. 2021 Jun 2;21(1):658. doi: 10.1186/s12885-021-08289-3.
The aim of this study was to analyze overall survival in endometrial cancer patients' FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy).
A population-based retrospective study of 7275 endometrial cancer patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses.
In univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18-1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95-1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival.
The minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.
本研究旨在分析 FIGO 分期 I-III 期子宫内膜癌患者的总生存率与手术方式的关系,即微创手术(MIS)或剖腹手术(腹腔镜手术)。
这是一项基于人群的回顾性研究,纳入了 2010 年至 2018 年期间在瑞典妇科癌症质量登记处诊断的 7275 例子宫内膜癌患者。采用 Cox 比例风险模型进行单变量和多变量生存分析。
单变量分析显示,与 MIS 相比,剖腹手术与较差的总生存率相关,风险比(HR)为 1.39(95%CI 1.18-1.63);而在多变量分析中,在调整了已知危险因素后,手术方式(MIS 与剖腹手术)与总生存率无关(HR 为 1.12,95%CI 0.95-1.32)。较高的 FIGO 分期、非子宫内膜样组织学、非二倍体肿瘤、淋巴血管间隙浸润和年龄增长是总生存率的独立危险因素。
当多变量分析中纳入已知预后危险因素时,微创手术或剖腹手术方式对 FIGO 分期 I-III 期子宫内膜癌患者的生存没有影响。