评估腹腔镜宫颈癌入路 (LACC) 试验对早期宫颈癌护理模式和手术相关发病率的影响。

这是一项回顾性、多机构研究，评估早期宫颈癌患者在（第一期：01/01/2016-06/01/2018）和之后（第二期）接受早期宫颈癌治疗的 90 天手术相关结果: 01/01/2019-06/01/2021) LACC 试验结果的公布。

评估了 1295 名患者的图表：分别在 LACC 试验发表前后分别有 581 名（44.9%）和 714 名（55.1%）。 LACC 试验发表后，接受微创根治性子宫切除术治疗的患者数量从 64.9% 下降到 30.4%（p < 0.001）。总体而言，在 I 期和 II 期分别有 110 名 (18.9%) 和 119 名 (16.6%) 患者发生了 90 天并发症 (p = 0.795)。同样，严重（3 级或更严重）并发症的数量在两个时期之间没有差异（38（6.5%）对 37（5.1%）；p = 0.297）。即使分别评估 IA 期 (p = 0.471)、IB1 (p = 0.929) 和 IB2 (p = 0.074) 期，总体和严重的 90 天并发症也是一致的。目前的调查强调，在转诊中心，从微创到开放根治性子宫切除术的转变不会影响 90 天手术相关的发病率。

Abstract

Background: To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer.

Methods: This is a retrospective, a multi-institutional study evaluating 90-day surgery-related outcomes of patients undergoing treatment for early-stage cervical cancer before (period I: 01/01/2016-06/01/2018) and after (period II: 01/01/2019-06/01/2021) the publication of the results of the LACC trial.

Results: Charts of 1295 patients were evaluated: 581 (44.9%) and 714 (55.1%) before and after the publication of the LACC trial, respectively. After the publication of the LACC trial, the number of patients treated with minimally invasive radical hysterectomy decreased from 64.9% to 30.4% (p < 0.001). Overall, 90-day complications occurred in 110 (18.9%) and 119 (16.6%) patients in the period I and period II, respectively (p = 0.795). Similarly, the number of severe (grade 3 or worse) complications did not differ between the two periods (38 (6.5%) vs. 37 (5.1%); p = 0.297). Overall and severe 90-day complications were consistent between periods even evaluating stage IA (p = 0.471), IB1 (p = 0.929), and IB2 (p = 0.074), separately.

Conclusions: The present investigation highlighted that in referral centers the shift from minimally invasive to open radical hysterectomy does not influence 90-day surgery-related morbidity.

Keywords: Complications; Laparoscopy; Morbidity; Radical hysterectomy.

原文链接

https://pubmed.ncbi.nlm.nih.gov/35909005/

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