1. Comparison of outcomes of laparotomic and minimally invasive radical hysterectomy in women with early-stage cervical cancer.
- Author
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Chang SH, Huang KG, Yang LY, Pan YB, Lai CH, and Chou HH
- Subjects
- Humans, Female, Middle Aged, Retrospective Studies, Adult, Operative Time, Length of Stay statistics & numerical data, Treatment Outcome, Postoperative Complications epidemiology, Postoperative Complications etiology, Disease-Free Survival, Robotic Surgical Procedures adverse effects, Robotic Surgical Procedures methods, Aged, Minimally Invasive Surgical Procedures methods, Minimally Invasive Surgical Procedures adverse effects, Blood Loss, Surgical statistics & numerical data, Laparotomy methods, Laparotomy adverse effects, Propensity Score, Blood Transfusion statistics & numerical data, Neoplasm Recurrence, Local epidemiology, Uterine Cervical Neoplasms surgery, Uterine Cervical Neoplasms pathology, Uterine Cervical Neoplasms mortality, Hysterectomy methods, Hysterectomy adverse effects, Neoplasm Staging, Laparoscopy methods, Laparoscopy adverse effects
- Abstract
Objective: This study compared the outcomes of laparotomic radical hysterectomy (LRH) and minimally invasive radical hysterectomy (MISRH) in patients with early-stage cervical cancer., Methods: The clinical data of patients with early-stage cervical cancer who underwent LRH or MISRH (laparoscopic/robotic) at Chang Gung Memorial Hospital, Linkou Branch, from 2002 to 2017 were retrospectively reviewed. The surgical safety (operation time, blood loss, blood transfusion rate, length of postoperative stay, and perioperative complications), overall survival (OS), disease-free survival (DFS), and recurrence pattern were analyzed. Propensity score matching (PSM) at a 3:1 ratio was performed to balance prognostic variables., Results: Of the 760 patients (entire cohort), 614 underwent LRH and 146 underwent MISRH. After PSM, 394 and 140 patients were included in the LRH and MISRH groups, respectively. The 5-year OS rate was significantly lower in the MISRH group than in the LRH group (85.6% vs. 93.2%, p=0.043), and the 5-year DFS rate (p=0.21) did not differ significantly. After PSM, the 5-year OS rates did not differ significantly between the MISRH and LRH groups (87.1% vs. 92.1%, p=0.393). The MISRH group had a significantly shorter operation time (p<0.001), lower intraoperative blood loss (p<0.001), lower blood transfusion rate (p<0.001), and shorter postoperative stay (p<0.001) but a significantly higher rate of intraoperative bladder injury (p<0.001) than the LRH group., Conclusion: After PSM, MISRH is associated with nonsignificantly lower OS but a significantly higher risk of intraoperative urological complications than LRH., Competing Interests: No potential conflict of interest relevant to this article was reported., (© 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.)
- Published
- 2024
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