文章：

根据ESMO/ESGO风险分类探讨手术方式对子宫内膜癌生存率的影响：一项意大利北部地区的回顾性多中心研究

Impact of a Surgical Approach on Endometrial Cancer Survival According to ESMO/ESGO Risk Classification: A Retrospective Multicenter Study in the Northern Italian Region

原文发布日期：7 July 2025

DOI: 10.3390/cancers17132261

类型: Article

开放获取: 是

英文摘要：

Background: Following the results of the Laparoscopic Approach to Carcinoma of the Cervix (LACC) trial, doubts have arisen about the safety of laparoscopy in the treatment of endometrial cancer.Methods:A retrospective multicenter cohort study which included all endometrial cancer (EC) patients who underwent a hysterectomy in Emilia Romagna hospitals from 2000 to 2019. All cases were revised and classified according to the 2009 International Federation of Gynaecology and Obstetrics (FIGO) staging system. The different impacts of the surgical approach on survival were stratified according to the recurrence risk from the 2016 European Society for Medical Oncology (ESMO)–European Society of Gynaecological Oncology (ESGO) classification system. The clinical characteristics and oncological outcome of patients treated by laparoscopy were compared with those treated by laparotomy.Results:A total of 2402 EC patients were included in the study. The use of laparoscopy has increased over the years, reaching 81% of procedures in 2019. Laparoscopy reduced complications and hospital stay. Laparoscopy was preferred to treat low, intermediate, and intermediate/high-risk patients. Laparoscopy showed no adverse effects on overall survival (OS) in any recurrence risk class. Particularly in high-risk EC patients, laparoscopy was associated with an increased OS in comparison with women treated by laparotomy regardless of the use of adjuvant therapy.Conclusions:Laparoscopy should always be chosen to treat EC of any risk class. The goal is to ensure correct treatment and oncological safety regardless of the surgical approach.

摘要翻译： 

背景：随着宫颈癌腹腔镜手术（LACC）试验结果的公布，腹腔镜在子宫内膜癌治疗中的安全性受到质疑。 方法：本研究为一项回顾性多中心队列研究，纳入2000年至2019年在艾米利亚-罗马涅大区医院接受子宫切除术的所有子宫内膜癌患者。所有病例均根据2009年国际妇产科联盟（FIGO）分期系统进行复核与分类，并依据2016年欧洲肿瘤内科学会（ESMO）与欧洲妇科肿瘤学会（ESGO）分类系统中的复发风险分层，分析不同手术方式对生存结局的影响。比较腹腔镜手术与开腹手术患者的临床特征及肿瘤学结局。 结果：研究共纳入2402例子宫内膜癌患者。腹腔镜手术使用率逐年上升，至2019年已达手术总量的81%。腹腔镜手术降低了并发症发生率并缩短了住院时间，更常用于治疗低危、中危及中高危患者。在各类复发风险分层中，腹腔镜手术均未对总生存期（OS）产生负面影响。尤其在高危子宫内膜癌患者中，无论是否接受辅助治疗，腹腔镜手术患者的OS均优于开腹手术患者。 结论：无论子宫内膜癌风险等级如何，均应优先选择腹腔镜手术治疗。核心目标是在确保规范治疗与肿瘤安全性的前提下，充分发挥不同手术方式的优势。

原文链接：

Impact of a Surgical Approach on Endometrial Cancer Survival According to ESMO/ESGO Risk Classification: A Retrospective Multicenter Study in the Northern Italian Region