腹腔镜或腹腔镜手术后病理I期卵巢癌患者的复发和生存的比较：倾向匹配的队列的回顾性分析
Comparison of Recurrence and Survival Between Patients With Pathological Stage I Epithelial Ovarian Cancer After Laparoscopic or Laparotomic Surgery: Retrospective Analysis of a Propensity-Matched Cohort
影响因子:3.30000
分区:医学2区 / 妇产科学2区
发表日期:2024 Nov
作者:
Si-Yu Cao, Yu Fan, Cheng-Yu Zhao, Yu-Fei Zhang, Yi Mu, Jin-Ke Li
摘要
To compare oncologic outcomes after laparoscopic or laparotomic surgery to treat epithelial ovarian carcinoma in FIGO Stage I.Retrospective cohort study.Gynecological cancer ward in a tertiary hospital.A total of 85 patients with FIGO Stage I epithelial ovarian carcinoma who underwent laparoscopic staging surgery and 206 who underwent laparotomic staging在2013年1月1日至2019年12月31日之间，西丘恩大学西部第二医院（中国成都）的手术。唇型手术或腹腔运动分期手术。在基于倾向得分的匹配之前，剖腹手术组显示出较高的术前CA125级别的患者（48.5％VS 35.3％和27.05）， vs 5.9％，p <.001）。多变量分析将较高体重指数与更好的总生存期相关（调整后的HR 0.83，95％CI 0.70-0.99，p = .043）。在根据年龄，体重指数，CA125水平，最大的肿瘤直径，figo阶段，腹部手术史，腹部手术史和美国麻醉师级的美国社会级别，5年之间的5年laparoscoppy 7％的患者（87）相似，在倾向评分匹配的患者（每组82名）中，他们根据年龄，体重指数，CA125水平，最大的肿瘤直径，腹部手术史，腹部手术史和美国的无效生存率（87％）（87）（87）（87）（87），剖腹术组（90.9％，95％CI 84.7-97.6％，p = .524），以及5年（93.9％，95％CI 88.0-100.0％vs 94.7％vs 94.7％，95％CI 89.8-99.9％，p = .900）的总生存率（93.9％，95％CI 88.0-100.0％）。无论是否匹配患者，两组在随访期间的复发率相似，持续54.9个月的中位数。复发和存活率可能相似，可以在治疗I期上皮卵巢癌的情况下相似。由于腹腔镜与较少的出血和更快的恢复有关，因此对于适当的患者来说，它可能是安全，有效的替代方法。
Abstract
To compare oncologic outcomes after laparoscopic or laparotomic surgery to treat epithelial ovarian carcinoma in FIGO Stage I.Retrospective cohort study.Gynecological cancer ward in a tertiary hospital.A total of 85 patients with FIGO Stage I epithelial ovarian carcinoma who underwent laparoscopic staging surgery and 206 who underwent laparotomic staging surgery at West China Second Hospital, Sichuan University (Chengdu, China) between January 1, 2013 and December 31, 2019.Laparoscopic surgery or laparotomic staging surgery.Before propensity score-based matching, the laparotomy group showed higher prevalence of preoperative elevated CA125 level (48.5% vs 35.3%, p = .045) and tumors >15 cm (27.2% vs 5.9%, p <.001). Multivariate analysis associated higher body mass index with better overall survival (adjusted HR 0.83, 95% CI 0.70-0.99, p = .043). Among propensity score-matched patients (82 per group) who were matched to each other according to propensity scoring based on age, body mass index, CA125 level, largest tumor diameter, FIGO stage, history of abdominal surgery, and American Society of Anesthesiologists grade, the rate of progression-free survival at 5 years was similar between the laparoscopy group (87.1%, 95% CI 79.3-95.7%) and the laparotomy group (90.9%, 95% CI 84.7-97.6%, p = .524), as was the rate of overall survival at 5 years (93.9%, 95% CI 88.0-100.0% vs 94.7%, 95% CI 89.8-99.9%, p = .900). Regardless of whether patients were matched, the two groups showed similar rates of recurrence of 9-11% during follow-up lasting a median of 54.9 months.Rates of recurrence and survival may be similar between laparoscopy or laparotomy to treat Stage I epithelial ovarian cancer. Since laparoscopy is associated with less bleeding and faster recovery, it may be a safe, effective alternative to laparotomy for appropriate patients.