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

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology Pub Date : 2024-11-01 DOI:10.1016/j.jmig.2024.07.005

Si-Yu Cao MD , Yu Fan MD , Cheng-Yu Zhao MD , Yu-Fei Zhang MD , Yi Mu PhD , Jin-Ke Li PhD

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引用次数: 0

Abstract

Objective

To compare oncologic outcomes after laparoscopic or laparotomic surgery to treat epithelial ovarian carcinoma in FIGO Stage I.

Design

Retrospective cohort study.

Setting

Gynecological cancer ward in a tertiary hospital.

Participants

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.

Interventions

Laparoscopic surgery or laparotomic staging surgery.

Results

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.

Conclusions

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.

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病理分期为 I 期的上皮性卵巢癌患者接受腹腔镜手术或开腹手术后的复发率和生存率比较：对倾向匹配队列的回顾性分析。

目的比较腹腔镜或开腹手术治疗FIGO I期上皮性卵巢癌的肿瘤治疗效果：设计：回顾性队列研究：地点：一家三级医院的妇科癌症病房：2013年1月1日至2019年12月31日期间，在四川大学华西第二医院（中国成都）接受腹腔镜分期手术的FIGO I期上皮性卵巢癌患者共85例，接受腹腔镜分期手术的患者共206例：结果：在基于倾向评分的匹配之前，开腹手术组术前CA125水平升高（48.5% vs 35.3%，P = .045）和肿瘤>15厘米（27.2% vs 5.9%，P < .001）的发生率更高。多变量分析显示，体重指数越高，总生存率越高（调整后 HR 0.83，95%CI 0.70-0.99，p = .043）。在根据年龄、体重指数、CA125水平、最大肿瘤直径、FIGO分期、腹部手术史和美国麻醉医师协会分级进行倾向评分匹配的患者（每组82人）中，腹腔镜组患者5年无进展生存率相似（87.1%，95%CI 79.3-95.7%）和开腹手术组（90.9%，95%CI 84.7-97.6%，P = .524）相似，5 年总生存率也相似（93.9%，95%CI 88.0-100.0% vs 94.7%，95%CI 89.8-99.9%，P = .900）。无论患者是否匹配，在中位数为 54.9 个月的随访期间，两组患者的复发率相似，均为 9-11%：结论：腹腔镜或开腹手术治疗I期上皮性卵巢癌的复发率和生存率可能相似。由于腹腔镜手术出血少、恢复快，因此对于合适的患者来说，腹腔镜手术可能是开腹手术的一种安全、有效的替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.