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早期宫颈癌的治疗模式和 90 天内与治疗相关的发病率。

Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer.

机构信息

Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.

Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.

出版信息

Gynecol Oncol. 2022 Sep;166(3):561-566. doi: 10.1016/j.ygyno.2022.07.022. Epub 2022 Jul 29.

Abstract

BACKGROUND

To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer.

METHODS

This is a retrospective, a multi-institutional study evaluating 90-day surgery-related outcomes of patients undergoing treatment for early-stage cervical cancer before (period I: 01/01/2016-06/01/2018) and after (period II: 01/01/2019-06/01/2021) the publication of the results of the LACC trial.

RESULTS

Charts of 1295 patients were evaluated: 581 (44.9%) and 714 (55.1%) before and after the publication of the LACC trial, respectively. After the publication of the LACC trial, the number of patients treated with minimally invasive radical hysterectomy decreased from 64.9% to 30.4% (p < 0.001). Overall, 90-day complications occurred in 110 (18.9%) and 119 (16.6%) patients in the period I and period II, respectively (p = 0.795). Similarly, the number of severe (grade 3 or worse) complications did not differ between the two periods (38 (6.5%) vs. 37 (5.1%); p = 0.297). Overall and severe 90-day complications were consistent between periods even evaluating stage IA (p = 0.471), IB1 (p = 0.929), and IB2 (p = 0.074), separately.

CONCLUSIONS

The present investigation highlighted that in referral centers the shift from minimally invasive to open radical hysterectomy does not influence 90-day surgery-related morbidity.

摘要

背景

评估腹腔镜宫颈癌治疗(LACC)试验对早期宫颈癌治疗模式和手术相关发病率的影响。

方法

这是一项回顾性、多机构研究,评估了 90 天内接受早期宫颈癌治疗的患者的手术相关结果,这些患者的治疗时间在 LACC 试验结果公布之前(第一期:2016 年 1 月 1 日至 2018 年 6 月 1 日)和之后(第二期:2019 年 1 月 1 日至 2021 年 6 月 1 日)。

结果

共评估了 1295 例患者的图表:第一期有 581 例(44.9%),第二期有 714 例(55.1%)。LACC 试验公布后,接受微创手术根治性子宫切除术的患者数量从 64.9%降至 30.4%(p<0.001)。总体而言,第一期和第二期分别有 110 例(18.9%)和 119 例(16.6%)患者发生 90 天并发症(p=0.795)。同样,两个时期严重(3 级或更高级别)并发症的数量也没有差异(38 例[6.5%]与 37 例[5.1%];p=0.297)。即使分别评估 IA 期(p=0.471)、IB1 期(p=0.929)和 IB2 期(p=0.074),两个时期的总体和严重 90 天并发症也一致。

结论

本研究强调,在转诊中心,从微创手术向开放性根治性子宫切除术的转变并不影响 90 天内的手术相关发病率。

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