Jianhao Sun, Zhenzhen Wu, Jiayu Chen, Qinglei Hang, Yaqin Zhao, Juan Li, Jie Huang, Xiaoli Zhao, Ji Xia, Xinjuan Jiao, Qing Liu, Dan Lu
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A non-inferiority test was employed for the analysis, with disease-free survival (DFS) serving as the primary outcome measure. DFS was evaluated using Kaplan-Meier curves, and comparisons were conducted through the log-rank test.</p><p><strong>Result: </strong>A cohort of 288 patients diagnosed with early-stage EC according to the 2009 FIGO staging system were re-evaluated and reclassified. Ultimately, the study encompassed a cohort of 80 patients diagnosed with stage II EC, as classified according to the 2023 FIGO staging system. 52 individuals underwent radical hysterectomy or modified radical hysterectomy (RH/mRH), while 28 patients received a simple hysterectomy (SH). The 5-year DFS was 84.62% for the RH/mRH group vs. 92.86% for the SH group (difference, 8.24% [95% CI, -5.44-21.92%]), which met the noninferiority criterion. Between the groups, the difference in 5-year DFS (p = 0.255) was not statistically significant. The laparoscope group comprised 62 cases, whereas the laparotomy group consisted of 18 cases. Between the groups, the difference in 5-year DFS (88.55% versus 83.33%, p = 0.538) was not statistically significant. This finding aligns with our observations of patients diagnosed with 2009 FIGO Stage II EC.</p><p><strong>Conclusion: </strong>In comparison to SH, RH/mRH did not confer a survival advantage for patients diagnosed with 2023 FIGO stage II EC.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"209"},"PeriodicalIF":1.6000,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079991/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparative analysis of hysterectomy types and approaches on oncological survival in 2023 FIGO stage II endometrial carcinoma.\",\"authors\":\"Jianhao Sun, Zhenzhen Wu, Jiayu Chen, Qinglei Hang, Yaqin Zhao, Juan Li, Jie Huang, Xiaoli Zhao, Ji Xia, Xinjuan Jiao, Qing Liu, Dan Lu\",\"doi\":\"10.1186/s12893-025-02937-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The objective is to investigate the relationship between the type and approaches of hysterectomy and the oncological survival outcomes in women diagnosed with stage II endometrial carcinoma (EC), as classified by the 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with 2009 FIGO early-stage (stages I and II) EC who underwent surgical treatment between 2018 and 2019. These patients were reclassified in accordance with the 2023 FIGO staging system, and those diagnosed with stage II EC under this system were selected as the study population. A non-inferiority test was employed for the analysis, with disease-free survival (DFS) serving as the primary outcome measure. DFS was evaluated using Kaplan-Meier curves, and comparisons were conducted through the log-rank test.</p><p><strong>Result: </strong>A cohort of 288 patients diagnosed with early-stage EC according to the 2009 FIGO staging system were re-evaluated and reclassified. Ultimately, the study encompassed a cohort of 80 patients diagnosed with stage II EC, as classified according to the 2023 FIGO staging system. 52 individuals underwent radical hysterectomy or modified radical hysterectomy (RH/mRH), while 28 patients received a simple hysterectomy (SH). 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引用次数: 0
摘要
背景：目的是研究2023年国际妇产科学联合会（FIGO）分期系统分类的II期子宫内膜癌（EC）女性子宫切除术类型和入路与肿瘤生存结局的关系。方法：回顾性分析2018 - 2019年接受手术治疗的2009年FIGO早期（I期和II期）EC患者。这些患者按照2023 FIGO分期系统重新分类，并选择在该系统下诊断为II期EC的患者作为研究人群。采用非劣效性检验进行分析，无病生存（DFS）作为主要结局指标。采用Kaplan-Meier曲线评价DFS，采用log-rank检验进行比较。结果：288例根据2009年FIGO分期系统诊断为早期EC的患者被重新评估和重新分类。最终，该研究纳入了80名诊断为II期EC的患者，根据2023年FIGO分期系统进行分类。52例患者行根治性子宫切除术或改良根治性子宫切除术（RH/mRH）， 28例患者行单纯子宫切除术（SH）。RH/mRH组的5年DFS为84.62%，SH组为92.86%（差异为8.24% [95% CI, -5.44-21.92%]），符合非劣效性标准。两组间5年DFS差异无统计学意义（p = 0.255）。腹腔镜组62例，开腹组18例。两组间5年DFS （88.55% vs 83.33%, p = 0.538）差异无统计学意义。这一发现与我们对诊断为2009年FIGO II期EC的患者的观察一致。结论：与SH相比，RH/mRH并没有给诊断为2023 FIGO II期EC的患者带来生存优势。
Comparative analysis of hysterectomy types and approaches on oncological survival in 2023 FIGO stage II endometrial carcinoma.
Background: The objective is to investigate the relationship between the type and approaches of hysterectomy and the oncological survival outcomes in women diagnosed with stage II endometrial carcinoma (EC), as classified by the 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system.
Methods: A retrospective analysis was conducted on patients with 2009 FIGO early-stage (stages I and II) EC who underwent surgical treatment between 2018 and 2019. These patients were reclassified in accordance with the 2023 FIGO staging system, and those diagnosed with stage II EC under this system were selected as the study population. A non-inferiority test was employed for the analysis, with disease-free survival (DFS) serving as the primary outcome measure. DFS was evaluated using Kaplan-Meier curves, and comparisons were conducted through the log-rank test.
Result: A cohort of 288 patients diagnosed with early-stage EC according to the 2009 FIGO staging system were re-evaluated and reclassified. Ultimately, the study encompassed a cohort of 80 patients diagnosed with stage II EC, as classified according to the 2023 FIGO staging system. 52 individuals underwent radical hysterectomy or modified radical hysterectomy (RH/mRH), while 28 patients received a simple hysterectomy (SH). The 5-year DFS was 84.62% for the RH/mRH group vs. 92.86% for the SH group (difference, 8.24% [95% CI, -5.44-21.92%]), which met the noninferiority criterion. Between the groups, the difference in 5-year DFS (p = 0.255) was not statistically significant. The laparoscope group comprised 62 cases, whereas the laparotomy group consisted of 18 cases. Between the groups, the difference in 5-year DFS (88.55% versus 83.33%, p = 0.538) was not statistically significant. This finding aligns with our observations of patients diagnosed with 2009 FIGO Stage II EC.
Conclusion: In comparison to SH, RH/mRH did not confer a survival advantage for patients diagnosed with 2023 FIGO stage II EC.
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