| Objective: Clinical data of early cervical cancer(Early-Stage Cervical Cancer,ECC)were compared by laparoscopy and laparotomyThe aim of this study was to analyze the effect of the two surgical methods on the survival outcome of patients with early cervical cancer(ECC)by comparing the clinical data of laparoscopic and laparotomy,and to explore the application value of the two surgical methods in the operation of patients with early cervical cancer.Methods:From august 1,2008 to august 31,2019,184 patients with early cervical cancer diagnosed by the same operation in the fourth hospital of hebei medical university were selected to collect the clinicopathological data of the above patients and follow up after the operation.the survival outcome of early cervical cancer patients in laparoscopic or open group was retrospectively analyzed.The SPSS R3.6.1 software was used for statistical analysis to describe age,body weight,body mass index(BMI),pathological type,etc.the counting data were used χ2 test or Fisher exact probability method.the progression-free survival and total survival were analyzed using Kaplan-Meier and statistically significant by log-rank sum test.P<0.05,the difference was statistically significant.Results:1 Laparoscopic of 119 cases of early cervical cancer in 2008-2019,50 cases as nodes for pre and late survival analysis,3y-PFS or 5y-PFS was not statistically significant(3y-PFS:98.0% vs.98.5%;5years PFS:93.5% vs.96.8%,P=0.72),3y-OS or 5y-OS was not statistically significant(3y-OS:98.0% vs.98.5%,;5y-OS:93.4% vs.96.3%,P=0.66).2 Early cervical cancer(IA1(LVSI)-IB1)survival outcomes in real-world conditions,There was no significant difference in 3y-PFS or 5y-PFS between laparoscopic and laparotomy(3y-PFS:97.4% vs.95.3%;5y-PFS :93.0%vs.95.3%,P=0.83),And there was no significant difference in 3y-OS or 5y-OS between laparoscopic and laparotomy(3y-OS:97.2% vs.96.9%;5y-OS:92.7%vs.95.3%,P=0.69).3 Survival outcome of early cervical cancer in different FIGO stages between laparoscopic and laparotomy.when the FIGO2009 wasⅠB1,There was no significant difference in 5y-PFS between laparoscopic and laparotomy(94.8% vs.95.2%,P=0.89),And there was no significant difference in 5y-OS between laparoscopic and laparotomy(94.5% vs.95.2%,P=0.95).when the FIGO2018 stage wasⅠB1,There was no significant difference in 5y-PFS between laparoscopic and laparotomy(93.3%vs.91.7%,P=0.45),And there was no significant difference in 5y-OS between laparoscopic and laparotomy(92.9%vs.91.7%,P=0.62).when the FIGO2018 stage was Ⅰ B2,There was no significant difference in 5y-PFS between laparoscopic and laparotomy(95.2%vs.97.0%,P=0.58),And there was no significant difference in 5y-OS between laparoscopic and laparotomy(94.9%vs.97.0%,P=0.64).4 Survival outcomes of laparoscopic and laparotomy for early cervical cancer with different tumor size.When the tumor size was less than 2cm,There was no significant difference in 5y-PFS between laparoscopic and laparotomy(89.5%vs.92.6%,P=0.87),And there was no significant difference in5y-OSbetween laparoscopic and laparotomy(89.2%vs.92.6%,P=0.95).When the tumor size was greater than or equal to 2cm and less than 4cm,There was no significant difference in 5y-PFS between laparoscopic and laparotomy(95.4%vs.97.3%,P=0.61),And there was no significant difference in 5y-OS between laparoscopic and laparotomy(95.2%vs.97.3%,P=0.55).5 There was no significant difference in PFS or OS between laparoscopic and laparotomy according to pathological type,depth of cervical interstitial infiltration and resection of para-aortic lymph nodes(P>0.05).6 Patients were locally advanced cervical cancer with FIGO2009 stageⅠB2 or FIGO2018 stage I B3,There was no significant difference in 5y-PFS between laparoscopic and laparotomy(87.0% vs.84.0%,P=0.22),And there was no significant difference in 5y-OS between laparoscopic and laparotomy(87.0% vs.81.4%,P=0.17).7 The LACC from 2018 study showed that for early cervical cancer patients,laparoscopic was less disease-free and overall survival than laparotomy.The 4.5-y survival rate was 10.5% lower in laparoscopic than in laparotomy(86.0%vs.96.5,95% CI,-16.4～-4.7),The 3-y overall survival rate was also lower than that of laparotomy(93.8%vs.99.0%,95%CI,1.77～20.3).The recurrence rate and risk of disease death in laparoscopic were 3.75 times higher than in laparotomy(95%CI,1.63～8.58).mortality in the laparoscopic was 6.56 times higher than in laparotomy(95% CI,1.48～29.00).Conclusion:1 The survival outcome of laparoscopic surgery in patients with early cervical cancer is not inferior to that of open surgery.2 Compared with the international large center and domestic large database,the survival rate of laparoscopy and laparotomy is not different,reaching the international and domestic standards. |
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