Department of Obstetrics and Gynecology, Osakea Saiseikai Nakatsu Hospital, Osaka, Japan.
Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan.
Jpn J Clin Oncol. 2023 Aug 30;53(9):791-797. doi: 10.1093/jjco/hyad067.
To compare the oncological outcomes between Japanese women who underwent minimally invasive surgery and those who underwent open surgery for early-stage endometrial cancer.
This population-based retrospective cohort study was conducted using data from the Osaka Cancer Registry from 2011 to 2018. Surgically treated patients for localized (uterine-confined) endometrial cancer were identified. Patients were classified into two groups according to the type of surgery (minimally invasive surgery group and open-surgery group), pathological risk factors (low-risk and high-risk), and year of diagnosis (Group 1, 2011-14; Group 2, 2015-18). Overall survival was compared between the minimally invasive surgery and open-surgery groups.
In the analyses including all patients, there was no difference in overall survival between the minimally invasive surgery and open-surgery groups (P = 0.0797). The 4-year overall survival rate was 97.1 and 95.7% in the minimally invasive surgery and open-surgery groups, respectively. When investigated according to pathological risks, there were no differences in overall survival between the minimally invasive surgery and open-surgery groups in both the low- and high-risk groups. In the low-risk group, the 4-year overall survival rates in the minimally invasive surgery and open-surgery groups were 97.7 and 96.5%, respectively. In the high-risk group, the 4-year overall survival rates in the minimally invasive surgery and open-surgery groups were 91.2 and 93.2%, respectively. Similarly, there were no differences in overall survival between the minimally invasive surgery and open-surgery groups in both Group 1 (P = 0.4479 in low-risk and P = 0.1826 in high-risk groups) and Group 2 (P = 0.1750 in low-risk and P = 0.0799 in high-risk groups).
Our study provides epidemiological evidence that minimally invasive surgery is an effective alternative to open surgery in Japanese patients with early-stage endometrial cancer.
比较日本早期子宫内膜癌患者接受微创手术和开放手术的肿瘤学结局。
本研究采用了 2011 年至 2018 年大阪癌症登记处的数据，进行了一项基于人群的回顾性队列研究。确定了接受局部（子宫内）子宫内膜癌手术治疗的患者。根据手术类型（微创手术组和开放手术组）、病理危险因素（低危和高危）和诊断年份（第 1 组，2011-14 年；第 2 组，2015-18 年）将患者分为两组。比较微创手术组和开放手术组之间的总生存率。
在包括所有患者的分析中，微创手术组和开放手术组之间的总生存率没有差异（P=0.0797）。微创手术组和开放手术组的 4 年总生存率分别为 97.1%和 95.7%。根据病理风险进行调查时，在低危和高危组中，微创手术组和开放手术组之间的总生存率均无差异。在低危组中，微创手术组和开放手术组的 4 年总生存率分别为 97.7%和 96.5%。在高危组中，微创手术组和开放手术组的 4 年总生存率分别为 91.2%和 93.2%。同样，在第 1 组（低危组 P=0.4479，高危组 P=0.1826）和第 2 组（低危组 P=0.1750，高危组 P=0.0799）中，微创手术组和开放手术组之间的总生存率也没有差异。
本研究提供了流行病学证据，表明在日本早期子宫内膜癌患者中，微创手术是开放手术的有效替代方法。
