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早期宫颈癌患者微创与腹式根治性子宫切除术的预后比较。

Comparison of Prognosis between Minimally Invasive and Abdominal Radical Hysterectomy for Patients with Early-Stage Cervical Cancer.

机构信息

Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan.

Translational Research Program, Educational Foundation of Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan.

出版信息

Curr Oncol. 2022 Mar 24;29(4):2272-2283. doi: 10.3390/curroncol29040185.

Abstract

Minimally invasive surgery (MIS) is performed to treat cervical cancer patients; however, a recent study showed that MIS was associated with higher recurrence and death rate compared with abdominal radical hysterectomy (ARH). In the current study, the prognosis of patients with early-stage cervical cancer who underwent MIS with vaginal closure or ARH was evaluated. One hundred and eighty-two patients underwent radical hysterectomy for cervical cancer with stage of IA2, IB1, and IIA1. MIS was performed by laparoscopy or a robot using the vaginal closure method. Disease-free survival (DFS) and overall survival (OS) were evaluated between the groups. Among the patients, 67 underwent MIS and 115 underwent ARH. The recurrence rate was 4.5% in MIS patients and 3.5% in ARH patients with a median follow-up (interquartile range) of 36 (18-60) and 78 (48-102) months, respectively. DFS and OS were not different between the groups (3y-DFS, 95.3% vs. 96.1%, = 0.6; 3y-OS, 100% vs. 100%, = 0.06). In early-stage cervical cancer patients, MIS with vaginal closure did not increase the risk for recurrence or death. Surgical techniques and procedures to avoid spillage of tumor cells could be important for a better prognosis.

摘要

微创手术 (MIS) 用于治疗宫颈癌患者;然而,最近的一项研究表明,与腹式根治性子宫切除术 (ARH) 相比,MIS 与更高的复发率和死亡率相关。在本研究中,评估了接受经阴道闭合的 MIS 或 ARH 的早期宫颈癌患者的预后。182 例 IA2、IB1 和 IIA1 期宫颈癌患者接受根治性子宫切除术。MIS 通过腹腔镜或机器人使用阴道闭合方法进行。评估两组之间的无病生存率 (DFS) 和总生存率 (OS)。其中 67 例患者接受 MIS,115 例患者接受 ARH。MIS 患者的复发率为 4.5%,ARH 患者的复发率为 3.5%,中位随访时间(四分位距)分别为 36(18-60)和 78(48-102)个月。两组之间 DFS 和 OS 无差异(3y-DFS,95.3% vs. 96.1%, = 0.6;3y-OS,100% vs. 100%, = 0.06)。在早期宫颈癌患者中,经阴道闭合的 MIS 不会增加复发或死亡的风险。避免肿瘤细胞外溢的手术技术和程序可能对更好的预后很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8763/9026697/519f1b94d366/curroncol-29-00185-g001.jpg

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