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PR023/#544  Feasibility and oncologic outcomes of laparoscopic radical hysterectomy incorporating modified tumour-free techniques: a propensity score weighted cohort study
  1. Yuan Li,
  2. Yang Xiang,
  3. Junjun Yang,
  4. Tong Ren,
  5. Jiayuan Zhao and
  6. Xuesong Ding
  1. Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Abstract

Introduction It remains unclear whether modifying laparoscopic radical hysterectomy (LRH) to adopt tumour-free principles can improve oncologic outcomes in patients with early-stage cervical cancer (ESCC).

Methods We performed a retrospective cohort study of 276 patients with ESCC treated between January 2017 and January 2023, including 151 who underwent LRH incorporating MTF techniques and 125 who underwent conventional LRH with a uterine manipulator and unprotected intracorporeal colpotomy. Oncologic outcomes and perioperative results were analyzed using multivariate analysis and inverse probability treatment weighting (IPTW).

Results The MTF group had a shorter length of hospital stay (6 vs. 7 days) than the non-MTF group. However, there were no significant differences in operative time, haemoglobin decrease and complications. After a median follow-up of 36.0 (range: 15.3–62.0) months for the MTF group and 66.8 (range: 3.0–82.5) months for the non-MTF group, recurrence was observed in 2 (1.3%) and 16 (12.8%) of the patients, respectively. The 2-, and 3-year DFS rate in the MTF group was 99.3%, and 98.0%, while the 2-, 3-, and 4.5-year DFS rates in the non-MTF group were 91.9%, 89.5%, and 87.8%, respectively. Adjusted multivariate analysis showed that MTF was an independent predictor of longer DFS (HR: 0.136, p=0.010). After IPTW, patients in the MTF group had more favorable DFS than those in the non-MTF group (log-rank p=0.001).

Conclusion/Implications LRH incorporating MTF techniques is a feasible treatment for patients with ESCC. Oncologic outcomes of individuals who underwent this procedure were similar to those of open approach, which was more favorable than those of conventional LRH.

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