微创根治性子宫切除术的预后比开放手术差，但预后不良的原因尚不清楚。当肿瘤暴露于手术区域时会发生肿瘤溢出，并被认为与不良预后有关。本研究旨在比较腹腔镜根治性子宫切除术中肿瘤溢出的预后价值，并评估肿瘤溢出预防是否可以提高肿瘤学安全性。我们比较了2014年12月至2021年11月期间接受腹腔镜根治性子宫切除术的有或没有肿瘤溢出预防的患者的预后，包括没有预防的手术和预防失败的手术。预防包括形成阴道套囊或用夹子封闭阴道管，以防止阴道切开时肿瘤暴露。主要终点是无病生存期，通过比较患者的倾向评分进行调整。总共 165 名患者接受了肿瘤溢出预防，61 名患者没有或未能接受此类预防。中位随访时间为 4.4 年。未接受预防或预防失败的患者的无病生存期明显短于接受预防的患者（风险比[HR]=3.54；95%置信区间[CI]=1.23-10.23）。调整倾向得分匹配后观察到相同的趋势。未接受或未能接受预防的患者更有可能出现局部复发（HR=4.01；95% CI=1.13-14.24）。预防肿瘤溢出与腹腔镜根治性子宫切除术中较长的无病生存期相关。© 2025。亚洲妇科肿瘤学会、韩国妇科肿瘤学会和日本妇科肿瘤学会。

Minimally invasive radical hysterectomy has a worse prognosis than open surgery, but the reasons for the poor prognosis remain unclear. Tumor spillage occurs when the tumor is exposed to the surgical field and has been suggested to be related to a poor prognosis. This study aimed to compare the prognostic value of tumor spillage in laparoscopic radical hysterectomy and evaluate whether tumor spillage prevention improves oncological safety.We compared the prognosis of patients who underwent laparoscopic radical hysterectomy between December 2014 and November 2021 with or without tumor spillage prevention, including surgeries without prevention and those with failed prevention. Prevention consisted of vaginal cuff formation or closure of the vaginal canal with clips to prevent tumor exposure at the time of colpotomy. The primary endpoint was disease-free survival, which was adjusted using propensity scores to compare patients.In total, 165 patients received tumor spillage prevention, and 61 did not or failed to receive such prevention. The median follow-up was 4.4 years. Patients who did not undergo prevention or failed prevention had significantly shorter disease-free survival than those who did (hazard ratio [HR]=3.54; 95% confidence interval [CI]=1.23-10.23). The same trend was observed after adjusting for propensity score matching. Patients who did not or failed to receive prevention were more likely to experience local recurrence (HR=4.01; 95% CI=1.13-14.24).Tumor spillage prevention was associated with longer disease-free survival in laparoscopic radical hysterectomy.© 2025. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.