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Comparison of outcomes of laparotomic and minimally invasive radical hysterectomy in women with early-stage cervical cancer.
- Source :
-
Journal of gynecologic oncology [J Gynecol Oncol] 2024 Sep; Vol. 35 (5), pp. e60. Date of Electronic Publication: 2024 Feb 23. - Publication Year :
- 2024
-
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.<br />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.<br />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.<br />Conclusion: After PSM, MISRH is associated with nonsignificantly lower OS but a significantly higher risk of intraoperative urological complications than LRH.<br />Competing Interests: No potential conflict of interest relevant to this article was reported.<br /> (© 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.)
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 2005-0399
- Volume :
- 35
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 38425140
- Full Text :
- https://doi.org/10.3802/jgo.2024.35.e60