Cui Hu1, Xi-Guang Mao2, Yu Xu3, Hui Xu4, Yi Liu5. 1. Department of Obstetrics and Gynecology, The Affiliated Hospital of Southwest Medical University (Drs. Hu and Mao), Luzhou; Department of Obstetrics and Gynecology, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University (Drs. Hu and Mao), Luzhou; School of Clinical Medicine, Southwest Medical University (Drs. Hu and Mao), Luzhou; Department of Obstetrics and Gynecology, Mianzhu People's Hospital, Mianzhu (Dr. Hu). 2. Department of Obstetrics and Gynecology, The Affiliated Hospital of Southwest Medical University (Drs. Hu and Mao), Luzhou; Department of Obstetrics and Gynecology, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University (Drs. Hu and Mao), Luzhou; School of Clinical Medicine, Southwest Medical University (Drs. Hu and Mao), Luzhou. Electronic address: xiguang_mao_smu@163.com. 3. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University (Dr. Y. Xu), Chengdu. 4. Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chengdu Medical College (Dr. H. Xu), Chengdu. 5. Department of Obstetrics and Gynecology, Mianyang Central Hospital, Mianyang, China.
Abstract
STUDY OBJECTIVE: To study the effect of different surgical approaches (laparoscopy and laparotomy) on the oncological outcomes of patients with apparent early-stage uterine clear cell carcinoma (UCCC). DESIGN: Retrospective cohort study. SETTING: Four Chinese teaching hospitals. PATIENTS: A total of 273 women with apparent early-stage UCCC. INTERVENTIONS: All included patients were surgically staged by laparoscopy or laparotomy. MEASUREMENTS AND MAIN RESULTS: The eligible patients were divided into the laparotomy group and the laparoscopy group. Disease-free survival (DFS) and overall survival (OS) were evaluated by the Kaplan-Meier method and compared by the log-rank test. The Cox proportional hazards regression model was used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the effect of surgical approach on DFS and OS. With a median follow-up of 31.0 months, the 3-year DFS rates were 68.82% and 64.27% in the laparotomy group and the laparoscopy group, respectively. The difference in DFS between the 2 groups was not statistically significant (HR, 1.06; 95% CI, 0.72-1.58; p = .758). In addition, the 3-year OS rate (72.76% vs 73.46%; HR, 1.06; 95% CI, 0.65-1.72; p = .823) was not different between the 2 groups. Furthermore, multivariable analysis showed that for patients with apparent early-stage UCCC, the approach of surgical staging was not an independent prognostic factor for OS (adjusted HR, 1.29; 95% CI, 0.78-2.12; p = .321) and DFS (adjusted HR, 1.11; 95% CI, 0.73-1.68; p = .621). CONCLUSION: For clinical early-stage clear cell carcinoma of the uterus, staging by laparoscopy is oncologically safe. This needs to be justified by further prospective studies.
STUDY OBJECTIVE: To study the effect of different surgical approaches (laparoscopy and laparotomy) on the oncological outcomes of patients with apparent early-stage uterine clear cell carcinoma (UCCC). DESIGN: Retrospective cohort study. SETTING: Four Chinese teaching hospitals. PATIENTS: A total of 273 women with apparent early-stage UCCC. INTERVENTIONS: All included patients were surgically staged by laparoscopy or laparotomy. MEASUREMENTS AND MAIN RESULTS: The eligible patients were divided into the laparotomy group and the laparoscopy group. Disease-free survival (DFS) and overall survival (OS) were evaluated by the Kaplan-Meier method and compared by the log-rank test. The Cox proportional hazards regression model was used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the effect of surgical approach on DFS and OS. With a median follow-up of 31.0 months, the 3-year DFS rates were 68.82% and 64.27% in the laparotomy group and the laparoscopy group, respectively. The difference in DFS between the 2 groups was not statistically significant (HR, 1.06; 95% CI, 0.72-1.58; p = .758). In addition, the 3-year OS rate (72.76% vs 73.46%; HR, 1.06; 95% CI, 0.65-1.72; p = .823) was not different between the 2 groups. Furthermore, multivariable analysis showed that for patients with apparent early-stage UCCC, the approach of surgical staging was not an independent prognostic factor for OS (adjusted HR, 1.29; 95% CI, 0.78-2.12; p = .321) and DFS (adjusted HR, 1.11; 95% CI, 0.73-1.68; p = .621). CONCLUSION: For clinical early-stage clear cell carcinoma of the uterus, staging by laparoscopy is oncologically safe. This needs to be justified by further prospective studies.