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机器人与腹腔镜根治性子宫切除术治疗早期宫颈癌的生存结局比较:系统评价和荟萃分析。

Comparison of survival outcomes between robotic and laparoscopic radical hysterectomies for early-stage cervical cancer: a systemic review and meta-analysis.

机构信息

Department of Obstetrics and Gynecology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.

Department of Obstetrics and Gynecology, Dongwon Cancer Specialized Care Hospital, Goyang, Korea.

出版信息

J Gynecol Oncol. 2024 Jan;35(1):e9. doi: 10.3802/jgo.2024.35.e9. Epub 2023 Sep 25.

Abstract

OBJECTIVE

Survival outcomes of robotic radical hysterectomy (RRH) remain controversial. Therefore, we performed a meta-analysis to evaluate survival outcomes between RRH) and laparoscopic radical hysterectomy (LRH) in patients with early-stage cervical cancer.

METHODS

Studies comparing between RRH and LRH published up to November 2022 were systemically searched in the PubMed, Cochrane Library, Web of Science, ScienceDirect, and Google Scholar databases. Manual searches of related articles and relevant bibliographies of the published studies were also performed. Two researchers independently extracted data. Studies with information on recurrence and death after minimally invasive radical hysterectomy were also included. The extracted data were analyzed using the Stata MP software package version 17.0.

RESULTS

Twenty eligible clinical trials were included in the meta-analysis. When all studies were pooled, the odds ratios of RRH for recurrence and death were 1.19 (95% confidence interval [CI]=0.91-1.55; p=0.613; I²=0.0%) and 0.96 (95% CI=0.65-1.42; p=0.558; I²=0.0%), respectively. In a subgroup analysis, the quality of study methodology, study size, country where the study was conducted, and publication year were not associated with survival outcomes between RRH and LRH.

CONCLUSION

This meta-analysis demonstrates that the survival outcomes are comparable between RRH and LRH.

TRIAL REGISTRATION

International Prospective Register of Systematic Reviews Identifier: CRD42023387916.

摘要

目的

机器人根治性子宫切除术(RRH)的生存结果仍存在争议。因此,我们进行了一项荟萃分析,以评估早期宫颈癌患者中 RRH 与腹腔镜根治性子宫切除术(LRH)的生存结果。

方法

系统检索了截至 2022 年 11 月发表的比较 RRH 和 LRH 的研究,检索了 PubMed、Cochrane 图书馆、Web of Science、ScienceDirect 和 Google Scholar 数据库。还手动搜索了相关文章和已发表研究的相关参考文献。两位研究人员独立提取数据。还包括微创根治性子宫切除术后复发和死亡信息的研究。使用 Stata MP 软件包版本 17.0 分析提取的数据。

结果

共有 20 项符合条件的临床试验纳入荟萃分析。当所有研究合并时,RRH 复发和死亡的优势比分别为 1.19(95%置信区间[CI]=0.91-1.55;p=0.613;I²=0.0%)和 0.96(95%CI=0.65-1.42;p=0.558;I²=0.0%)。亚组分析显示,研究方法学质量、研究规模、研究所在国家和发表年份与 RRH 和 LRH 之间的生存结果无关。

结论

这项荟萃分析表明,RRH 和 LRH 的生存结果相当。

试验注册

国际前瞻性系统评价注册中心标识符:CRD42023387916。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adb6/10792214/58c963ff83c1/jgo-35-e9-g001.jpg

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