Clinical Analysis Of Surgical Treatment In Early-stage Cervical Cancer

Objective: This paper retrospectively analyze the cases of early-stage cervical cancer treated by surgery in Affiliated hospital of Zunyi medical university,and discuss the prognosis and related influencing factors of different surgical methods in the treatments of early-stage cervical cancer,so as to provide reference for clinical work.Methods: Clinical data of 205 patients with early-stage cervical cancer who underwent surgical treatments in Affiliated hospital of Zunyi medical university from January 2011 to December 2015 are collected.Follow-up studies are put into effect to conform the prognosis and recurrence,and they are divided into open group and laparoscopic group for retrospective analysis.SPSS26.0 software is used to analyze the data.Numeration data is expressed as percentage(%),measurement data is tested by t test,and enumeration data is tested by chi-square test,non-parametric test and Fisher’s exact test.Kaplan-Meier method is used to calculate the survival rate.P<0.05 is considered statistically significant.Results: 1.The age range of patients including in this study: 27-70 years old,with an average age of 46.72±9.15 years old.The age range of high incidence: 40-46 years old,comparing with the data of China’s 2015 cancer census,the patients are younger;There is no significant difference between the open group and the laparoscopic group(P>0.05).2.There are no significant differences in the first symptoms,clinicopathological features(clinical stage,pathological classification,histological grade,cervical interstitial infiltration,lymphatic vascular space infiltration),operative duration,postoperative adjuvant treatment,recurrence and survival between the two groups(P>0.05).3.Intraperitoneal blood loss: the mean value of the open group is 586.4±451.7ml,and the mean value of the laparoscopic group is 220±147.9ml.The amount of intraoperative blood loss in the open group is more than that in the laparoscopic group,and the difference is statistically significant(P<0.001).4.Postoperative conditions: 1)Postoperative exhaust time: The postoperative exhaust time of the included patients in this study range from 1-5 days,with an average of 3.1±0.8 days in the open group and 2.4±0.8 days in the laparoscopic group;The postoperative exhaust time of the open group is slower than that of the laparoscopic group,and the difference between the two groups is statistically significant(P<0.001).2)Length of postoperative hospital stay: The length of postoperative hospital stay of the including patients in this study range from 5 to 54 days,with an average postoperative hospital stay of 13.8±6.9 days;The mean postoperative hospital stay is 14.4±5.8 days in the open group and 11.9±9.4 days in the laparoscopic group.The length of postoperative hospital stay in the open group is longer than that in the laparoscopic group,and the difference between the two groups is statistically significant(P<0.05).3)Postoperative complications: The major postoperative complications of the including patients in this study included urinary tract injury in 12 cases,thrombosis in 7 cases,poor healing of abdominal wall incision in 12 cases,poor healing of vaginal stump in 2 cases,anemia in 23 cases,and multiple complications in 6 cases;Among them,56 cases(90.3%)are in the open group and 6 cases(9.7%)in the laparoscopic group.The difference between the two groups is statistically significant(P<0.001).5.Survival: 5-year overall survival(OS)rate is 94.1%,and 5-year disease-free survival(DFS)rate is 89.8%.The 5-year OS rate and 5-year DFS rate are 93.6% and89.1% in the open group.The 5-year OS rate and 5-year DFS rate in the laparoscopic group are 95.9% and 91.8% respectively.There is no significant difference in 5-year OS rate and 5-year DFS rate between the two groups(P>0.05).Conclusion: 1.The peak age of 205 patients with early-stage cervical cancer treated by our hospital is 40-46 years old,which is younger than the national cancer census data.2.The amount of intraoperative blood loss in the laparoscopic group is less than that in the open group.If there is cervical interstitial infiltration,the operation duration would be longer.The postoperative gastrointestinal recovery time of laparoscopic group is earlier than that of open group.The length of postoperative hospital stay is shorter in the laparoscopic group.There is no significant difference in tumor outcome and prognosis between laparoscopic group and open group in our hospital.3.In the case data included in this study,the 5-year overall survival rate is 94.1%,93.6% in the open group and 95.9% in the laparoscopic group.The 5-year disease-free survival rate is 89.8%,89.1% in the open group and 91.8% in the laparoscopic group.