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- Title
Impact of surgical approach on progress of disease by type of histology in stage IA endometrial cancer: a matched-pair analysis.
- Authors
Miao, Huixian; Zhang, Lin; Jiang, Yi; Wan, Yicong; Yuan, Lin; Cheng, Wenjun
- Abstract
Background: To compare the impact of surgical approach on progression free survival (PFS) stratified by histologic type in women diagnosed with stage IA endometrial cancer. Methods: Myometrial invasion is classified into no myometrial invasion, <50% and ≥50%, with only no myometrial invasion and <50% are included in stage IA patients. A retrospective study is designed by collecting data from women diagnosed as stage IA endometrial cancer from January 2010 to December 2019 in a tertiary hospital. A propensity score is conducted for 1:1 matching in the low-risk histologic patients. Progression free survival and disease-specific survival data are evaluated by the Kaplan–Meier method and compared by the log-rank test in both the whole population and the matched-pair groups. A sub-group analysis is performed to figure out risk factors associated with the effect of surgical approach on PFS and disease-specific survival (DSS). Results: 534 (84.49%) low-risk histologic endometrial cancer women, with 389 (72.85%) operated by minimally invasive surgery and 145 (27.15%) by open approach, and 98 (15.51%) high-risk histology, with 71 (72.45%) by laparoscopy and 27 (27.55%) by open surgery, are included. Compared to open surgery, laparoscopy results in lower progression free survival in low-risk patients before and after matching (p = 0.039 and p = 0.033, respectively), but shows no difference in high-risk patients (p = 0.519). Myometrial invasion is associated with lower progression free survival in laparoscopy in low-risk histology (p = 0.027). Conclusion: Surgical approaches influence progression free survival in stage IA low-risk histologic diseases, especially in those with myometrial invasion, but not in high-risk histologic endometrial cancer.
- Subjects
ENDOMETRIAL cancer; PROGRESSION-free survival; ENDOMETRIAL surgery; MINIMALLY invasive procedures; LOG-rank test; HISTOLOGY
- Publication
BMC Surgery, 2024, Vol 24, Issue 1, p1
- ISSN
1471-2482
- Publication type
Article
- DOI
10.1186/s12893-023-02299-7