BMC Cancer:早期宫颈癌根治性子宫切除:腹腔镜vs.开腹?

2015-12-22 MedSci译 MedSci原创

研究者检索了PubMed、MEDLINE、EMBASE、the Cochrane Library和BIOSIS数据库上关于早期宫颈癌患者腹腔镜下根治性子宫切除(LRH)和开腹根治性子宫切除(RH)比较的研究,比较了两种不同术式的围手术期结局、肿瘤清除情况、并发症和长期结局。最终纳入了12项比较LRH(n = 754)和RH(n = 785)的研究。分析数据显示,与RH相比,LRH可显著减少术中出血

研究者检索了PubMed、MEDLINE、EMBASE、the Cochrane Library和BIOSIS数据库上关于早期宫颈癌患者腹腔镜下根治性子宫切除(LRH)和开腹根治性子宫切除(RH)比较的研究,比较了两种不同术式的围手术期结局、肿瘤清除情况、并发症和长期结局。

最终纳入了12项比较LRH(n = 754)和RH(n = 785)的研究。分析数据显示,与RH相比,LRH可显著减少术中出血量(加权均数差 = -268.4 mL;95 % CI -361.6, -175.1; p < 0.01),术后并发症也会更少(OR = 0.46; 95 % CI 0.34-0.63) ,住院时间也更短(加权均数差 = -3.22 天; 95 % CI-4.21, -2.23 days; p < 0.01),但手术时间更长 (加权均数差 = 26.9 分钟;95 % CI 8.08-45.82)。两组术中并发症发生率差异不大,切除淋巴结和切缘肿瘤阳性率在两组间差异也不大,除此之外,5年整体生存(HR 0.91, 95 % CI 0.48-1.71; p = 0.76)和5年无病生存仍无差异(HR 0.97, 95 % CI 0.56-1.68; p = 0.91)。

研究表明,早期宫颈癌患者LRH与RH相比有更好的短期结局,5年生存在两组间相似。

原始出处:

Wang YZ, Deng L,et al.Laparoscopy versus laparotomy for the management of early stage cervical cancer.BMC Cancer. 2015 Nov 24;15:928.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1709245, encodeId=67641e09245b4, content=<a href='/topic/show?id=5b354516591' target=_blank style='color:#2F92EE;'>#子宫切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45165, encryptionId=5b354516591, topicName=子宫切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=982231632710, createdName=12498aa2m72(暂无昵称), createdTime=Mon Aug 08 19:48:00 CST 2016, time=2016-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974652, encodeId=a7bc19e465293, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Wed May 25 19:48:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276348, encodeId=54ed12e634886, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407964, encodeId=919e140e9648a, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586020, encodeId=eb6f1586020f9, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1709245, encodeId=67641e09245b4, content=<a href='/topic/show?id=5b354516591' target=_blank style='color:#2F92EE;'>#子宫切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45165, encryptionId=5b354516591, topicName=子宫切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=982231632710, createdName=12498aa2m72(暂无昵称), createdTime=Mon Aug 08 19:48:00 CST 2016, time=2016-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974652, encodeId=a7bc19e465293, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Wed May 25 19:48:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276348, encodeId=54ed12e634886, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407964, encodeId=919e140e9648a, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586020, encodeId=eb6f1586020f9, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1709245, encodeId=67641e09245b4, content=<a href='/topic/show?id=5b354516591' target=_blank style='color:#2F92EE;'>#子宫切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45165, encryptionId=5b354516591, topicName=子宫切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=982231632710, createdName=12498aa2m72(暂无昵称), createdTime=Mon Aug 08 19:48:00 CST 2016, time=2016-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974652, encodeId=a7bc19e465293, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Wed May 25 19:48:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276348, encodeId=54ed12e634886, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407964, encodeId=919e140e9648a, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586020, encodeId=eb6f1586020f9, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1709245, encodeId=67641e09245b4, content=<a href='/topic/show?id=5b354516591' target=_blank style='color:#2F92EE;'>#子宫切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45165, encryptionId=5b354516591, topicName=子宫切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=982231632710, createdName=12498aa2m72(暂无昵称), createdTime=Mon Aug 08 19:48:00 CST 2016, time=2016-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974652, encodeId=a7bc19e465293, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Wed May 25 19:48:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276348, encodeId=54ed12e634886, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407964, encodeId=919e140e9648a, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586020, encodeId=eb6f1586020f9, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=)]
    2015-12-24 一闲
  5. [GetPortalCommentsPageByObjectIdResponse(id=1709245, encodeId=67641e09245b4, content=<a href='/topic/show?id=5b354516591' target=_blank style='color:#2F92EE;'>#子宫切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45165, encryptionId=5b354516591, topicName=子宫切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=982231632710, createdName=12498aa2m72(暂无昵称), createdTime=Mon Aug 08 19:48:00 CST 2016, time=2016-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974652, encodeId=a7bc19e465293, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Wed May 25 19:48:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276348, encodeId=54ed12e634886, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407964, encodeId=919e140e9648a, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586020, encodeId=eb6f1586020f9, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Thu Dec 24 13:48:00 CST 2015, time=2015-12-24, status=1, ipAttribution=)]
    2015-12-24 jeanqiuqiu

相关资讯

Am J Obstet Gynecol:宫颈癌的生存趋势

目的:近30年宫颈癌的治疗取得了巨大的进展,对于人群水平的生存率是否得到改善,仍然不清楚。研究调查相对生存率,宫颈癌的生存率与不同时间对照比较。设计:研究1983年-2009年间记录在Surveillance、Epidemiology和End Results数据库,被诊断为宫颈癌的病人。生存模型由年龄、种族、分期、每年的诊断和诊断后的时间来调整。比较宫颈癌病人具体分期的相关生存变化和与总人口匹配的

一对生死冤家,HPV与宫颈癌!

宫颈癌是女性常见的恶性肿瘤,在我国每年新发病例约15万,每年有3万多的妇女死于宫颈癌。但是子宫颈癌是目前唯一病因明确、可以预防的恶性肿瘤。它的元凶就是高危型HPV的持续性感染。 HPV是个什么鬼? HPV就是人类乳头状瘤病毒,是一种嗜上皮性病毒,有高度特异性的球形DNA病毒,病毒DNA以整合形式存在于宿主细胞中。能引起人体皮肤黏膜的鳞状上皮增殖如寻常疣、生殖器疣(尖锐湿疣)等。

The Lancet Oncol:预防宫颈癌,打一针就行!

宫颈癌是全球最致命但也是最容易预防的女性癌症类型,人乳头瘤病毒(HPV)感染是罪魁祸首,导致了99%的宫颈癌病例,其中2种基因型(HPV-16/18)占到了70%。接种疫苗是预防宫颈癌的一种有效手段,当前宫颈癌疫苗的免疫程序通常为2针(0,6个月)或者3针(0,1,6个月)。然而令人担忧的现实情况是,有相当多的年轻女性并没有按规定及时地完成2针或3针注注射。这是否会降低疫苗预防HPV感染的效果呢?

Lancet Oncol:CP化疗中加入西地尼布,治疗宫颈癌可提高疗效 (CIRCCa研究)

对转移或复发宫颈癌患者进行传统标准的化疗,疗效很差,反应率仅为20-30%,并且整体生存率很难超过1年。肿瘤血管生成过多和瘤体内 VEGF 浓度过高是该疾病预后差的特征之一。西地尼布是一个对VEGFR1, 2, 3均有效的酪氨酸激酶抑制剂。研究者进行了一项试验,评估对转移或复发宫颈癌患者在卡铂+紫杉醇化疗基础上,添加西地尼布后效果如何。此项随机、双盲、安慰剂对照的2期试验在英国的17家医疗中心进行

CA权威回顾--癌症可以药物预防吗?

可以预防的癌症 乳腺癌 宫颈癌 食道癌 预防

欧洲药品管理局启动HPV疫苗安全性调查

近日,欧洲药品管理局(EMA)将针对广泛使用的两种预防宫颈癌的疫苗展开安全性调查。这次调查主要针对的HPV疫苗包括葛兰素史克的Cervarix和默沙东的Gardasil/Silgard(新版本Gardasil 9刚刚获批,这两种疫苗获批已经接近十年了。 欧洲药品管理局这次主要针对已经报道的两种副反应——复杂局部疼痛综合征(CRPS)以及体位性心动过速综合征(PoTS),他们试图调查清楚这两种副反