机器人辅助腹腔镜手术与传统腹腔镜手术治疗临床子宫局限性高级别腺癌的肿瘤学和围手术期结果。

IF 3.4 2区 医学 Q2 ONCOLOGY
Annals of Surgical Oncology Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI:10.1245/s10434-024-16029-7
Christian Dagher, Yu Hui Lim, Yukio Sonoda, Lila Marshall, Kara Long Roche, Elizabeth Jewell, Dennis S Chi, Ginger Gardner, Vance Broach, Jennifer J Mueller, Nadeem R Abu-Rustum, Mario M Leitao
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引用次数: 0

摘要

研究目的本研究旨在比较机器人辅助腹腔镜(RA)和传统腹腔镜(LSC)治疗明显的临床子宫局限性高级别腺癌的肿瘤学和围手术期疗效:本院对2009年1月1日至2021年6月30日期间新确诊的高级别子宫腺癌患者进行了回顾性研究。排除标准包括巨大子宫外疾病、未进行淋巴结评估或同步肿瘤。临床病理资料来自医疗记录。术后并发症采用纪念斯隆-凯特琳癌症中心外科次要事件系统进行分类,并采用适当的检验方法进行统计分析:在确定的901例患者中,748例(83%)接受了RA手术,153例(17%)接受了LSC手术。中位年龄为 65 岁(25-92 岁不等),中位体重指数为 30 公斤/平方米(15-60 公斤/平方米不等)。总体而言,650 名患者(72%)的疾病处于 2009 年国际妇产科联盟(FIGO)I 期。41名患者(4.6%)转为开腹手术--26名(3.5%)来自RA,15名(9.8%)来自LSC(P = 0.02)。81名患者(9.0%)发生了术后并发症,两组患者的并发症类型和发生率无明显差异。RA的中位手术时间为192分钟(范围88-936),而LSC为168分钟(范围90-372)(P = 0.002)。RA的中位随访时间为52个月(1-163个月),LSC为66个月(7-165个月)。两组患者的四年无进展生存期(PFS)和疾病特异性生存期(DSS)相似。多变量分析表明,分期、组织学、腹腔细胞学和淋巴管侵犯预示着PFS和DSS的下降:结论:在高级别子宫内膜癌患者中,RA的肿瘤治疗效果与LSC相当,术后并发症和长期生存率没有显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Oncologic and Perioperative Outcomes of Robot-Assisted Versus Conventional Laparoscopy for the Treatment of Clinically Uterine-Confined High-Grade Adenocarcinoma.

Objective: The aim of this study was to compare oncologic and perioperative outcomes of robot-assisted laparoscopy (RA) and conventional laparoscopy (LSC) in apparent clinically uterine-confined, high-grade adenocarcinoma.

Methods: A retrospective review was conducted to identify patients with newly diagnosed high-grade uterine adenocarcinoma treated at our institution between 1 January 2009 and 30 June 2021. Exclusion criteria included bulky extrauterine disease, no lymph node assessment, or synchronous tumors. Clinicopathologic details were obtained from medical records. Postoperative complications were classified using the Memorial Sloan Kettering Cancer Center Surgical Secondary Events system, and statistical analysis was performed using appropriate tests.

Results: Of 901 patients identified, 748 (83%) underwent RA and 153 (17%) underwent LSC. Median age was 65 years (range 25-92) and median body mass index was 30 kg/m2 (range 15-60). Overall, 650 patients (72%) had 2009 International Federation of Obstetrics and Gynecology (FIGO) stage I disease. Forty-one patients (4.6%) converted to laparotomy-26 (3.5%) from RA versus 15 (9.8%) from LSC (p = 0.02). Postoperative complications occurred in 81 patients (9.0%), with no significant differences in type or rate between groups. Median operative time was 192 mins (range 88-936) for RA versus 168 mins (range 90-372) for LSC (p = 0.002). Median follow-up was 52 months (range 1-163) for RA and 66 months (range 7-165) for LSC. Four-year progression-free survival (PFS) and disease-specific survival (DSS) were similar between groups. Multivariate analysis showed stage, histology, peritoneal cytology, and lymphovascular invasion predicated a decrease in PFS and DSS.

Conclusions: RA demonstrated comparable oncologic outcomes to LSC in patients with high-grade endometrial carcinoma, with no significant difference in postoperative complications or long-term survival.

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来源期刊
CiteScore
5.90
自引率
10.80%
发文量
1698
审稿时长
2.8 months
期刊介绍: The Annals of Surgical Oncology is the official journal of The Society of Surgical Oncology and is published for the Society by Springer. The Annals publishes original and educational manuscripts about oncology for surgeons from all specialities in academic and community settings.
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