Comparison of Minimally Invasive Versus Abdominal Radical Hysterectomy for Early-Stage Cervical Cancer: An Updated Meta-Analysis

Frontiers in Oncology

Oncology

Liying Ying¹  Yuexiu Si²  Xiangyuan Li³  Jingyi Shen³  Wei Dai³  Mengting Zhang³  Yetan Shi³  Ke Jiang³ 

[1] Department of Obstetrics and Gynecology, Ningbo Yinzhou No. 2 Hospital, Ningbo, China;School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China;The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China;

关键词: abdominal radical hysterectomy;    early-stage cervical cancer;    prognosis;    meta-analysis;    minimally invasive surgery;   

DOI  :  10.3389/fonc.2021.762921

 received in 2021-08-23, accepted in 2021-12-30,  发布年份 2022

来源: Frontiers

【 摘 要 】

BackgroundAlthough minimally invasive surgery (MIS) was commonly used to treat patients with early-stage cervical cancer, its efficacy remained controversial.MethodsWe systematically searched PubMed, Web of Science, and Cochrane Library databases until March 2021 to compare the prognosis of early-stage cervical cancer patients who underwent MIS (laparoscopic or robot-assisted radical hysterectomy) or ARH. The primary outcomes included rates of 3- and 5-year disease-free survival (DFS) and overall survival (OS). The study protocol was registered in PROSPERO: CRD42021258116.ResultsThis meta-analysis included 48 studies involving 23346 patients (11220, MIS group; 12126, ARH group). The MIS group had a poorer medium-term (3-year) DFS (HR=1.08, 95% CI: 1.01-1.16, p=0.031) than the ARH group, without significant difference in medium-term OS as well as long-term (5-year) DFS and OS. Subgroup analysis of 3-year prognosis revealed that although patients in Western countries who underwent MIS had shorter DFS than those who underwent ARH (HR=1.10, p=0.024), no difference was observed in DFS among those in Asian countries. Moreover, MIS was linked to poorer 3-year DFS in patients with stage I cervical cancer (HR=1.07, p=0.020). Notably, subgroup analysis of 5-year prognosis revealed that patients with tumor size ≥2 cm undergoing MIS exhibited a shorter DFS than those who underwent ARH (HR=1.65, p=0.041).ConclusionPatients with early-stage cervical cancer undergoing MIS may have a poorer prognosis than those undergoing ARH. Therefore, applying MIS in early-stage cervical cancer patients should be conducted with caution.Systematic Review RegistrationThe study protocol was registered in PROSPERO: CRD42021258116.

【 授权许可】

Unknown   
Copyright © 2022 Zhang, Dai, Si, Shi, Li, Jiang, Shen and Ying