Pengfei Li1, Lan Chen1, Yan Ni2, Jiaqi Liu1, Donglin Li3, Jianxin Guo4, Zhihua Liu5, Shuangling Jin6, Yan Xu7, Zhiqiang Li1, Lu Wang1, Xiaonong Bin8, Jinghe Lang1,9, Ping Liu1, Chunlin Chen10. 1. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China. 2. Department of Obstetrics and Gynecology, Yuncheng Central Hospital, Yuncheng, China. 3. Department of Obstetrics and Gynecology, Guizhou people's Hospital, Guiyang, China. 4. Department of Obstetrics and Gynecology, Daping Hospital, Army Medical University, Chongqing, China. 5. Department of Gynecology, Shenzhen Maternal and Child Health Hospital, Shenzhen, China. 6. Department of Obstetrics and Gynecology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China. 7. Department of Obstetrics and Gynecology, Pan Yu Central Hospital, Guangzhou, China. 8. Department of Epidemiology, College of Public Health, Guangzhou Medical University, Guangzhou, China. 9. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China. 10. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China. ccl1@smu.edu.cn.
Abstract
OBJECTIVE: To compare 5-year disease-free survival (DFS) and overall survival (OS) rates of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for stage IB1 and tumor size <2 cm with visible or invisible tumors. METHODS: We retrospectively compared the oncological outcomes of 1,484 cervical cancer patients with IB1 and tumor size <2 cm on final pathology, who received ARH (n=899) or LRH (n=585) between January 2004 and December 2016. Patients were divided into visible tumor subgroup (ARH: n=668, LRH: n=444) and invisible tumor subgroup (ARH: n=231, LRH: n=141) according to tumor type. RESULTS: LRH and ARH showed similar 5-year DFS and OS rates (93.3% vs. 93.1%, p=0.997; 96.2% vs. 97.5%, p=0.351) in total study population. LRH was not associated with worse 5-year DFS rate (hazard ratio [HR]=0.96; 95% confidence interval [CI]=0.58-1.58; p=0.871) or OS rate (HR=1.37; 95% CI=0.65-2.89; p=0.409) by multivariable analysis. In the visible tumor subgroups, LRH and ARH showed similar 5-year DFS and OS rates (91.9% vs. 91.9%, p=0.933; 95.0% vs. 96.9%, p=0.276), and LRH was not associated with worse 5-year DFS or OS rate (p=0.804, p=0.324). In the invisible tumor subgroups, LRH and ARH also showed similar 5-year DFS and OS rates (97.3% vs. 97.1%, p=0.815; 100% vs. 99.5%, p=0.449), and LRH was not associated with worse 5-year DFS rate (p=0.723). CONCLUSIONS: Among patients with stage IB1 and tumor size <2 cm, whether the tumor is visible or not, the oncological outcomes of LRH and ARH among cervical cancer patients are comparable. This suggests that LRH may be suitable for stage IB1 and tumor size <2 cm with visible or invisible tumors. TRIAL REGISTRATION: International Clinical Trials Registry Platform Identifier: CHiCTR180017778.
OBJECTIVE: To compare 5-year disease-free survival (DFS) and overall survival (OS) rates of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for stage IB1 and tumor size <2 cm with visible or invisible tumors. METHODS: We retrospectively compared the oncological outcomes of 1,484 cervical cancerpatients with IB1 and tumor size <2 cm on final pathology, who received ARH (n=899) or LRH (n=585) between January 2004 and December 2016. Patients were divided into visible tumor subgroup (ARH: n=668, LRH: n=444) and invisible tumor subgroup (ARH: n=231, LRH: n=141) according to tumor type. RESULTS: LRH and ARH showed similar 5-year DFS and OS rates (93.3% vs. 93.1%, p=0.997; 96.2% vs. 97.5%, p=0.351) in total study population. LRH was not associated with worse 5-year DFS rate (hazard ratio [HR]=0.96; 95% confidence interval [CI]=0.58-1.58; p=0.871) or OS rate (HR=1.37; 95% CI=0.65-2.89; p=0.409) by multivariable analysis. In the visible tumor subgroups, LRH and ARH showed similar 5-year DFS and OS rates (91.9% vs. 91.9%, p=0.933; 95.0% vs. 96.9%, p=0.276), and LRH was not associated with worse 5-year DFS or OS rate (p=0.804, p=0.324). In the invisible tumor subgroups, LRH and ARH also showed similar 5-year DFS and OS rates (97.3% vs. 97.1%, p=0.815; 100% vs. 99.5%, p=0.449), and LRH was not associated with worse 5-year DFS rate (p=0.723). CONCLUSIONS: Among patients with stage IB1 and tumor size <2 cm, whether the tumor is visible or not, the oncological outcomes of LRH and ARH among cervical cancerpatients are comparable. This suggests that LRH may be suitable for stage IB1 and tumor size <2 cm with visible or invisible tumors. TRIAL REGISTRATION: International Clinical Trials Registry Platform Identifier: CHiCTR180017778.