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FIGO 分期 IB1-IB2 期宫颈癌的复发模式:微创与经腹广泛子宫切除术的比较。

Patterns of recurrence in FIGO stage IB1-IB2 cervical cancer: Comparison between minimally invasive and abdominal radical hysterectomy.

机构信息

Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Rome, Italy.

Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Rome, Italy.

出版信息

Eur J Surg Oncol. 2023 Nov;49(11):107047. doi: 10.1016/j.ejso.2023.107047. Epub 2023 Sep 10.

Abstract

OBJECTIVE

Aim of our study was to evaluate whether the different laparotomic (ARH) or minimally invasive (laparoscopic and robotic) approaches (MIS) in FIGO stage IB1-IB2 cervical cancer, present different patterns of recurrence of the disease. The secondary endpoint of the study was the evaluation of the variables most involved with the risk of relapse and therefore lower DFS and OS.

MATERIAL AND METHODS

The study enrolled patients with definitive histological diagnosis of squamous or adenocarcinoma stage IB1-IB2 cervical cancer who underwent minimally invasive or abdominal radical hysterectomy from 2001 to 2018.

RESULTS

The study enrolled 360 patients and 59 patients (16.4 %) reported a disease relapse. The data showed that ARH group was not associated with different recurrence patterns than MIS group (p = 0.14). Moreover, there was no statistically significant difference regarding DFS (p = 0.52) and OS (p = 0.29) between the ARH group and the MIS group.

CONCLUSIONS

MIS, in FIGO stage IB1-IB2 cervical cancer, is not associated with different relapse patterns compared to ARH, nor with a higher risk of distance metastasis and finally, without significant difference in term of DFS and OS. More studies are needed to determine the factors that modify the site of relapse.

摘要

目的

本研究旨在评估 FIGO 分期 IB1-IB2 宫颈癌的剖腹手术(ARH)或微创(腹腔镜和机器人)方法(MIS)是否存在不同的疾病复发模式。本研究的次要终点是评估与复发风险相关的变量,从而降低无病生存率(DFS)和总生存率(OS)。

材料和方法

本研究纳入了 2001 年至 2018 年间接受微创或腹式根治性子宫切除术治疗的明确组织学诊断为鳞状细胞癌或腺癌、FIGO 分期 IB1-IB2 宫颈癌的患者。

结果

本研究共纳入 360 例患者,其中 59 例(16.4%)患者出现疾病复发。数据显示,ARH 组与 MIS 组的复发模式无差异(p=0.14)。此外,ARH 组与 MIS 组在 DFS(p=0.52)和 OS(p=0.29)方面无统计学差异。

结论

与 ARH 相比,MIS 在 FIGO 分期 IB1-IB2 宫颈癌中并不与不同的复发模式相关,也不增加远处转移的风险,最终在 DFS 和 OS 方面没有显著差异。需要进一步研究来确定改变复发部位的因素。

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