Comparison between laparoscopic and abdominal radical hysterectomy for cervical adenosquamous carcinoma at stage IA2 to IIA2: A multicenter retrospective study

Author:

Teng Xiaohui1ORCID,Kang Shan2,Li Weili1,Ding Hongmei3,Ling Bin4,Zhu Lin5,Wang Danbo6,Lang Jinghe17,Liu Ping1ORCID,Chen Chunlin1ORCID

Affiliation:

1. Department of Obstetrics and Gynecology, Nanfang Hospital Southern Medical University Guangzhou China

2. Department of Gynecology The Forth Hospital of Hebei Medical University Shijiazhuang China

3. Department of Gynecology Yunfu City First People's Hospital Yunfu China

4. Department of Obstetrics and Gynecology China‐Japan Friendship Hospital Beijing China

5. Department of Gynecology Second Hospital of Shandong University Jinan China

6. Department of Gynecology Liaoning Cancer Hospital Shenyang China

7. Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science Beijing China

Abstract

AbstractObjectiveWe aimed to compare the 5‐year oncological outcomes of laparoscopic/abdominal radical hysterectomy (LRH/ARH) in patients with cervical adenosquamous carcinoma at stage IA2 to IIA2 based on the 2009 or 2018 International Federation of Gynecology and Obstetrics (FIGO) staging criteria.MethodsBased on the clinical diagnosis and treatment of cervical cancer in China (Four C) database, Cox risk regression models were applied to analyze tumor prognosis treated with ARH/LRH in FIGO 2009 and 2018 IA2‐IIA2 patients and stratified findings according to tumor diameter (≤4 and >4 cm subgroups). And to avoid bias, propensity score matching (PSM) was also used for the cohort study.ResultsBased on FIGO 2009 staging criteria (n = 474), there was no significant difference between the ARH and LRH groups in 5‐year disease‐free survival (DFS) or overall survival (OS). Lymph node metastasis was a risk factor for 5‐year DFS in this stage. After PSM, lymphovascular space invasion (LVSI) was an independent risk factor for 5‐year OS in the tumors ≤4 cm subgroup. Based on FIGO2018 staging criteria (n = 322), cervical interstitial infiltration depth was an independent risk factor for 5‐year OS in the total population and the tumor diameter ≤4 cm subgroup.ConclusionsLaparoscopic surgery was not a risk factor affecting the oncologic prognosis of adenosquamous carcinoma of the cervix based on either FIGO 2009 or 2018 staging of stage IA2‐IIA2. In addition, LRH may be considered for patients with early‐stage cervical adenosquamous carcinoma.

Publisher

Wiley

Subject

Obstetrics and Gynecology

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