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Laparoscopic versus abdominal radical hysterectomy for stage IB1 cervical cancer patients with tumor size ≤ 2 cm: a case-matched control study

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Abstract

Background

To investigate the survival outcomes of stage IB1 cervical cancer patients with tumor size ≤ 2 cm who underwent laparoscopic or abdominal radical hysterectomy.

Methods

We retrospectively analyzed stage IB1 cervical cancer patients with a tumor size ≤ 2 cm who underwent laparoscopic or abdominal radical hysterectomy in China between 2004 and 2016. A real-world study (RWS) and 1:1 matching was used in the study.

Results

After 1:1 matching, laparoscopic (n = 926) and abdominal radical hysterectomy (n = 926) had similar 5-year overall survival and disease-free survival rates in stage IB1 cervical cancer with a tumor size ≤ 2 cm. Subsequently, in cervical squamous carcinoma with tumor size ≤ 2 cm, the laparoscopic and abdominal groups (724 cases, respectively) showed comparable 5-year overall survival and disease-free survival rates. Finally, in cervical adenocarcinoma or adenosquamous carcinoma with tumor size ≤ 2 cm, the laparoscopic group (n = 174) had a similar 5-year overall survival rate but a lower disease-free survival rate compared to those of the abdominal group (disease-free survival: 89.9% vs. 98.0%, respectively, P = 0.006; hazard ratio (HR), 5.094; 95% confidence interval (CI), 1.400–18.535; P = 0.013; n = 174). The RWS results were similar to the 1:1 matching results.

Conclusions

Patients with squamous cell carcinoma in stage IB1 cervical cancer with tumor size ≤ 2 cm might be suitable for laparoscopic surgery, while patients with adenocarcinoma or adenosquamous carcinoma with tumor size ≤ 2 cm are not candidates for laparoscopic surgery.

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Acknowledgements

This study was supported by the National Science and Technology Support Program of China (2014BAI05B03), the National Natural Science Fund of Guangdong (2015A030311024), and the Science and Technology Plan of Guangzhou (158100075). We are grateful to Min Hao (Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University), Wuliang Wang (Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University), Ying Yang (Department of Obstetrics and Gynecology, Xinqiao Hospital, Army Medical University), Shan Kang (Department of Obstetrics and Gynecology, The Fourth Hospital of Hebei Medical University), Bin Ling (Department of Obstetrics and Gynecology, China-Japan Friendship Hospital), Xinli Sun and Hongwei Zhao (Department of Gynecology, Shanxi Cancer Hospital), Lizhi Liang and Jihong Liu (Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center), Yu Guo and Lihong Lin (Department of Gynecology, Anyang Tumor Hospital), Li Wang (Department of Gynecology, The Affiliated Tumor Hospital of Zhengzhou University), Weidong Zhao (Department of Gynecology and Oncology, Anhui Provincial Cancer Hospital), Donglin Li and Wentong Zhao (Department of Obstetrics and Gynecology, Guizhou Provincial People’s Hospital), Jianxin Guo (Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, The Third Military Medical University), Xuemei Zhan and Mingwei Li (Department of Gynecology, Jiangmen Central Hospital), Weifeng Zhang (Department of Obstetrics and Gynecology, Ningbo Women & Children's Hospital), Peiyan Du (Department of Gynecological Oncology, the Affiliated Cancer Hospital and Institute of Guangzhou Medical University), Ziyu Fang (Department of Obstetrics and Gynecology, Liuzhou Workers' Hospital), Rui Yang (Department of Obstetrics and Gynecology, Shenzhen Hospital of Peking University), Long Chen (Department of Obstetrics and Gynecology, Qingdao Municipal Hospital), Encheng Dai and Ruilei Liu (Department of Obstetrics and Gynecology, Linyi People's Hospital), Mubiao Liu and Yuanli He (Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University), Jilong Yao and Zhihua Liu (Department of Obstetrics and Gynecology, Shenzhen Maternity & Child Health Hospital), Xueqin Wang (Department of Obstetrics and Gynecology, The Fifth Affiliated Hospital of Southern Medical University), Anwei Lu (Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Guiyang Province), Shuangling Jin (Department of Obstetrics and Gynecology, Peace Hospital affiliated to Changzhi Medical College), Ben Ma (Department of Obstetrics and Gynecology, Guangzhou First People's Hospital), Zhonghai Wang (Department of Obstetrics and Gynecology, Shenzhen Nanshan People's Hospital), Lin Zhu (Department of Gynecology, The Second Hospital of Shandong University), Hongxin Pan (Department of Obstetrics and Gynecology, the 3rd Affiliated Hospital of Shenzhen University, Luohu People's Hospital), Qianyong Zhu [Department of Obstetrics and Gynecology, No. 153, Center Hospital of Liberation Army (Hospital No. 988 of the Chinese People's Liberation Army Joint Support Force)], Xiaohong Wang [Department of Obstetrics and Gynecology, Laiwu People's Hospital (Jinan City People's Hospital)], and Dingyuan Zeng and Zhong Lin (Department of Obstetrics and Gynecology, Maternal and Child Health Care Hospital of Liuzhou) for providing cases.

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Author notes

  1. Chunlin Chen, Ping Liu, Yan Ni, and Lian Tang contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, China

    Chunlin Chen, Ping Liu, Lian Tang & Jinghe Lang

  2. Department of Gynecology, Yuncheng Central Hospital, Yuncheng, Shanxi, China

    Yan Ni

  3. Department of Obstetrics and Gynecology, Pan Yu Central Hospital, Guangzhou, China

    Yan Xu

  4. Department of Epidemiology, College of Public Health, Guangzhou Medical University, Guangzhou, China

    Xiaonong Bin

  5. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China

    Jinghe Lang

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  1. Chunlin Chen
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Correspondence to Chunlin Chen.

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Chen, C., Liu, P., Ni, Y. et al. Laparoscopic versus abdominal radical hysterectomy for stage IB1 cervical cancer patients with tumor size ≤ 2 cm: a case-matched control study . Int J Clin Oncol 25, 937–947 (2020). https://doi.org/10.1007/s10147-020-01630-z

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  • DOI: https://doi.org/10.1007/s10147-020-01630-z

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