Impact on survival and quality of life of laparoscopic radical hysterectomy and pelvic lymphadenectomy to patients with early-stage cervical cancer
10.3760/cma.j.issn.0529-567x.2011.11.014
- VernacularTitle:腹腔镜下广泛性子宫切除术治疗早期子宫颈癌的疗效及对患者预后和生命质量的影响
- Author:
Zhijun YANG
;
Yanli CHEN
;
Desheng YAO
;
Jieqing ZHANG
;
Fei LI
;
Li LI
- Publication Type:Journal Article
- Keywords:
Uterine cervical neoplasms;
Laparoscopy;
Hysterectomy;
Lymph node excision;
Quality of life
- From:
Chinese Journal of Obstetrics and Gynecology
2011;46(11):854-859
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare intraoperative,pathologic,postoperative outcomes and quality of life of laparoscopic radical hysterectomy and pelvic lymphadenectomy ( LRH + LPL) with abdominal radical hysterectomy and pelvic lymphadenectomy ( ARH + APL) for patients with early-stage cervical cancer.Methods The consecutive cases with International Federation of Gynecology and Obstetrics (FIGO) stages Ⅰ a2 - Ⅱ a cervical cancer who underwent surgery from Jan.1,2002 to Jan.1,2011 were documented,including 85 patients underwent LRH + LPL,and 85 patients underwent ARH + APL as control group.The clinical data of intraoperative,pathologic,postoperative outcomes and quality of life were compared between two groups.Survival data were estimated using Kaplan-Meier survival curves and compared with the log-rank test.Cox proportional hazards model was used for multivariate analysis.Results All but 2 surgical procedures were completed laparoscopically because of right common ihac vein vessel injuries.Mean operative time,it was longer for LRH + LPL than that for ARH + APL [ (242 ±74) minutes vs.( 190 ±61 ) minutes,P =0.000 ].Mean recovery time of intestines function was less for LRH + LPL than that for ARH + APL [ (45 ± 7 ) hours vs.(63 ± 1 1 ) hours,P =0.000 ].Mean estimated blood loss was less for LRH + LPL than that for ARH + APL[ (367 ±252) ml vs.(460 ±220) ml,P =0.006].Mean recovery time of urinary function was less that for LRH + LPL than that for ARH + APL [ ( 19 ±4) days vs.(21 ±4) days,P =0.000 ].There were no significant difference in numbers of the pelvic lymph nodes resected,the extent of parametrial tissue,vaginal cuff,negative margins obtained and complications.The median follow-up was 32 months (range 4 to 105 months),there was no significant difference in the recurrence rate (7％ vs.5％,P=0.540) and mortality rate (7％ vs.5％,P=0.540),5 years disease-free survival(90％ vs.94％,P =0.812),5 years over survival ( 90％ vs.95％,P =0.532 ).There were not significant difference in quality of life between ARH + APL group and LRH + LPL group( P ＞ 0.05 ).Only lympho-vascular space invasion was an independent prognostic factor by multivariate analysis (P =0.016).Conclusions For early stage cervical cancer,LRH + LPL has similar outcomes compared with ARH + APL.Laparoscopic treatment by experienced surgeons should be an ideal altemative.
