宫颈癌 || 微创根治性子宫切除术的无病生存期

2021-01-22 张师前 张师前公众号

美国密歇根大学Uppal等报告的一项多机构回顾性系列研究显示,接受微创根治性子宫切除术(包括最终病理学上确定肿瘤≤ 2 cm的患者,其无病生存期(DFS)较差,但整个队列的总生存率均较好。(J

美国密歇根大学Uppal等报告的一项多机构回顾性系列研究显示,接受微创根治性子宫切除术(包括最终病理学上确定肿瘤≤ 2 cm的患者,其无病生存期(DFS)较差,但整个队列的总生存率均较好。(J Clin Oncol. 2020 doi:10.1200/JCO.19.03012.

该研究旨在比较在学术医疗机构中进行的开放性和微创性RH之间的DFS201011日至20171231日,该项回顾性多机构研究对A1期(伴有淋巴管浸润),A2期和B1期鳞状、腺癌或腺鳞癌的RH患者进行了回顾。

815例患者中,开放性RH255例(29.1%),微创RH560例(70.9%)。在开放性 RH组中有19例(7.5%)复发,微创组中有51例(9.1%)复发(P=0.43)。风险校正后的分析表明,微创性 RH 与复发风险增加独立相关(HR=1.8895 CI 1.04-3.25)。与复发风险增加独立相关的其他因素包括肿瘤大小、疾病等级和辅助放疗。术前锥切术与较低的复发风险相关(HR=0.495 CI 0.23-0.71)。在未经校正的分析(HR=1.1495 CI 0.61-2.11)中或校正风险后(HR=1.0195 CI  0.5-2.2),两组的OS没有差异。在264例最终病理确诊≤ 2 cm 的患者(不包括最终病理没有残留肿瘤的患者)中,开放性RH组复发率为2.4%(2/82),而微创性RH组复发率为8.8%(16/182P=0.058)。在倾向性评分匹配分析中,开放性RH组的复发率为4.4 %(7/159),而微创性RH组的复发率为11.5%(18/156P=0.019)。生存分析显示,倾向性匹配队列中微创组复发风险增加(HR=2.8395 CI 1.1-7.18)。

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    2021-01-24 hb2008ye
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    2021-01-24 jeanqiuqiu

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