부산대학교 도서관

연구배경: Cervical cancer is still most common gynecologic malignancy in South Korea. Traditionally, early stage cervical cancer was treated by radical hysterectomy and advanced stage cervical cancer was treated by concurrent chemoradiation. After minimally invasive surgery (MIS) was introduced, the incidence of MIS compared to open surgery increased gradually.Many studies showed similar oncologic outcome between minimally invasive surgery and open surgery. But, in november 2018, results from the Laparoscopic Approach to Cervical Cancer (LACC) trial were published in NEJM indicating that patients undergoing minimally invasive radical hysterectomy have a lower rate of disease-free survival and overall survival than those who undergo abdominal radical hysterectomy. This is an extremely important trial that has the potential to cause a paradigm shift in how cervical cancer is managed and therefore led us to further evaluate the data from our institution. Our objective was to compare risks of recurrence, and survival in a cohort of women undergoing open radical hysterectomy versus minimally invasive radical hysterectomy (MIS) for early stage cervical cancer at a single institution. 대상 및 방법: In this single institution retrospective study, we reviewed medical records of patients who underwent radical hysterectomy for cervical cancer between Jan. 2010 and Dec. 2019. patients with pathologically confirmed 2018 FIGO stage IB1 to IIA2 cervical cancer were included and were grouped by minimally invasive and abdominal radical hysterectomy. Tumor characteristics, recurrence rate, disease-free survival (DFS), and overall survival (OS) were compared between groups. 결과: In total, 148 patients met out inclusion criteria. 38 patients underwent open surgery (25.7%), and 110 underwent MIS (74.3%). There were 17 recurrences (11.5%) in the entire cohort at the time of analysis. Recurrences occurred in 15 (13.6%) of 110 MIS patients and 2 (5.3%) of 38 open surgery patients. Recurrence rate was higher in MIS group, but there was no significant difference between the groups (p=0.179). DFS (36.7 vs 45.5 months, p = 0.267), and OS (37.8 vs 50.4 months, p = 0.952) were similar between the two groups.Recurrence rate was significantly higher in MIS group for patients with tumor>2cm. In patients with tumor>2cm, MIS group had significantly poorer DFS than open surgery group (p=0.017; Fig. 2), although OS was similar between the two groups (p=0.252; Fig. 2). 결론: In conclusion, in patients with tumor size >2 cm, MIS was associated with higher recurrence rates and poorer DFS than open surgery. However, in patients with tumor size ≤2 cm, MIS did not seem to compromise oncologic outcomes.