Cargando…

Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China

Study Objective: To compare the surgical and oncologic outcomes between open abdomen radical hysterectomy (ARH) and laparoscopic radical hysterectomy (LRH) for cervical cancer. Methods: Retrospective observational study with propensity score matching was used to ensure balanced groups for ARH and LR...

Descripción completa

Detalles Bibliográficos
Autores principales: Yuan, Zhen, Cao, Dongyan, Yang, Jie, Yu, Mei, Shen, Keng, Yang, Jiaxin, Zhang, Ying, Zhou, Huimei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833183/
https://www.ncbi.nlm.nih.gov/pubmed/31737563
http://dx.doi.org/10.3389/fonc.2019.01107
_version_ 1783466322240208896
author Yuan, Zhen
Cao, Dongyan
Yang, Jie
Yu, Mei
Shen, Keng
Yang, Jiaxin
Zhang, Ying
Zhou, Huimei
author_facet Yuan, Zhen
Cao, Dongyan
Yang, Jie
Yu, Mei
Shen, Keng
Yang, Jiaxin
Zhang, Ying
Zhou, Huimei
author_sort Yuan, Zhen
collection PubMed
description Study Objective: To compare the surgical and oncologic outcomes between open abdomen radical hysterectomy (ARH) and laparoscopic radical hysterectomy (LRH) for cervical cancer. Methods: Retrospective observational study with propensity score matching was used to ensure balanced groups for ARH and LRH. One-hundred-and-ninety-eight women with cervical cancer, 99 treated using ARH and 99 using LRH, between January 2012 and December 2014. Outcomes included disease-free survival (DFS), overall survival (OS), intra-operative factors, post-operator recovery, urinary retention, and adverse events. Moreover, the inverse probability of the treatment weighting (IPTW) method was also used. Main Results: Compared with ARH, LRH was associated with a lower volume of blood loss (P < 0.001) and transfusion rate (P < 0.001), with a broader resection of the parametrium (P < 0.001). Post-operatively, the time to first flatus was shorter for LRH than ARH (P < 0.001) but the rate of urinary retention was higher for LRH (22.2%) than ARH (8.1%; P = 0.009). DFS and OS were similar between groups. By IPTW, laparoscopy was also not associated with poorer survival in terms of DFS (HR 1.52, CI 0.799–2.891, P = 0.202) or OS (HR 0.942, HR 0.425–2.09, P = 0.883). Conclusion: Compared with ARH, LRH provided better intra-operative and post-operative outcomes, with no significant difference in oncologic outcomes and survival. Urinary retention remains a clinical issue to improve with LRH. The technology of LRH has been improved in China to address the inconsistent results of oncologic outcomes in previous studies. Whether these improvements could be effective needs to be investigated in the future.
format Online
Article
Text
id pubmed-6833183
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-68331832019-11-15 Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China Yuan, Zhen Cao, Dongyan Yang, Jie Yu, Mei Shen, Keng Yang, Jiaxin Zhang, Ying Zhou, Huimei Front Oncol Oncology Study Objective: To compare the surgical and oncologic outcomes between open abdomen radical hysterectomy (ARH) and laparoscopic radical hysterectomy (LRH) for cervical cancer. Methods: Retrospective observational study with propensity score matching was used to ensure balanced groups for ARH and LRH. One-hundred-and-ninety-eight women with cervical cancer, 99 treated using ARH and 99 using LRH, between January 2012 and December 2014. Outcomes included disease-free survival (DFS), overall survival (OS), intra-operative factors, post-operator recovery, urinary retention, and adverse events. Moreover, the inverse probability of the treatment weighting (IPTW) method was also used. Main Results: Compared with ARH, LRH was associated with a lower volume of blood loss (P < 0.001) and transfusion rate (P < 0.001), with a broader resection of the parametrium (P < 0.001). Post-operatively, the time to first flatus was shorter for LRH than ARH (P < 0.001) but the rate of urinary retention was higher for LRH (22.2%) than ARH (8.1%; P = 0.009). DFS and OS were similar between groups. By IPTW, laparoscopy was also not associated with poorer survival in terms of DFS (HR 1.52, CI 0.799–2.891, P = 0.202) or OS (HR 0.942, HR 0.425–2.09, P = 0.883). Conclusion: Compared with ARH, LRH provided better intra-operative and post-operative outcomes, with no significant difference in oncologic outcomes and survival. Urinary retention remains a clinical issue to improve with LRH. The technology of LRH has been improved in China to address the inconsistent results of oncologic outcomes in previous studies. Whether these improvements could be effective needs to be investigated in the future. Frontiers Media S.A. 2019-10-30 /pmc/articles/PMC6833183/ /pubmed/31737563 http://dx.doi.org/10.3389/fonc.2019.01107 Text en Copyright © 2019 Yuan, Cao, Yang, Yu, Shen, Yang, Zhang and Zhou. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Yuan, Zhen
Cao, Dongyan
Yang, Jie
Yu, Mei
Shen, Keng
Yang, Jiaxin
Zhang, Ying
Zhou, Huimei
Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China
title Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China
title_full Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China
title_fullStr Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China
title_full_unstemmed Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China
title_short Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China
title_sort laparoscopic vs. open abdominal radical hysterectomy for cervical cancer: a single-institution, propensity score matching study in china
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833183/
https://www.ncbi.nlm.nih.gov/pubmed/31737563
http://dx.doi.org/10.3389/fonc.2019.01107
work_keys_str_mv AT yuanzhen laparoscopicvsopenabdominalradicalhysterectomyforcervicalcancerasingleinstitutionpropensityscorematchingstudyinchina
AT caodongyan laparoscopicvsopenabdominalradicalhysterectomyforcervicalcancerasingleinstitutionpropensityscorematchingstudyinchina
AT yangjie laparoscopicvsopenabdominalradicalhysterectomyforcervicalcancerasingleinstitutionpropensityscorematchingstudyinchina
AT yumei laparoscopicvsopenabdominalradicalhysterectomyforcervicalcancerasingleinstitutionpropensityscorematchingstudyinchina
AT shenkeng laparoscopicvsopenabdominalradicalhysterectomyforcervicalcancerasingleinstitutionpropensityscorematchingstudyinchina
AT yangjiaxin laparoscopicvsopenabdominalradicalhysterectomyforcervicalcancerasingleinstitutionpropensityscorematchingstudyinchina
AT zhangying laparoscopicvsopenabdominalradicalhysterectomyforcervicalcancerasingleinstitutionpropensityscorematchingstudyinchina
AT zhouhuimei laparoscopicvsopenabdominalradicalhysterectomyforcervicalcancerasingleinstitutionpropensityscorematchingstudyinchina