Comparison between laparoscopic and abdominal radical hysterectomy for low-risk cervical cancer: a multicentre retrospective study

作者：Li, Zhiqiang; Chen, Chunlin^*; Liu, Ping; Lu, Anwei; Zhao, Hongwei; Zhan, Xuemei; Duan, Hui; Li, Pengfei; Zhao, Weidong; Yao, Jilong; Li, Donglin; Jiang, Haixia; Liu, Mubiao; Bin, Xiaonong; Lang, Jinghe^*

来源：ARCHIVES OF GYNECOLOGY AND OBSTETRICS, 2022, 305(2): 449-458.

DOI：10.1007/s00404-021-06185-6

• Cervical cancer
• Laparoscopic
• Radical hysterectomy
• Pathologic risk factors
• Gynaecological oncology

Purpose To compare oncological outcomes of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for low-risk cervical cancer. Method We retrospectively compared the 3-year overall survival (OS) and 3-year disease-free survival (DFS) of 1269 low-risk cervical cancer patients with FIGO 2009 stage IA2, IB1 and IIA1 with a tumour size < 2 cm, no lymphovascular space invasion (LVSI), superficial stromal invasion and no lymph node involvement on imaging, and who received LRH (n = 672) and ARH (n = 597) between 2009 and 2018 at 47 hospitals. Results In the total study population, LRH and ARH showed similar 3-year OS (98.6% vs. 98.9%, P = 0.850) and DFS rates (95.7% vs. 96.4%, P = 0.285). LRH was not associated with worse 3-year OS (HR 0.897, 95% CI 0.287-2.808, P = 0.852) or DFS (HR 0.692, 95% CI 0.379-1.263, P = 0.230) as determined by multivariable analysis. After propensity score matching in 1269 patients, LRH (n = 551) and ARH (n = 551) still showed similar 3-year OS (98.4% vs. 98.8%, P = 0.704) and DFS rates (95.5% vs. 96.3%, P = 0.249). LRH was still not associated with worse 3-year OS (HR 0.816, 95% CI 0.262-2.541, P = 0.725) or DFS (HR 0.694, 95% CI 0.371-1.296, P = 0.251). Conclusion Among patients with low-risk cervical cancers < 2 cm, no LVSI, superficial stromal invasion, and no lymph node involvement on imaging, no significant differences were observed in 3-year OS or DFS rates between LRH and ARH.

• 单位
  广州医学院; 南方医科大学; 广东省人民医院; 中山大学; 中国医学科学院北京协和医院