| Objective: Recent studies have shown that minimally invasive surgery(MIS)is associated with a higher recurrence rate in patients with early-stage cervical cancer.Our primary aim is to report the survival outcomes of patients with early-stage cervical cancer,with the secondary aim of exploring the risk factors that influence prognosis.Method: The medical records of patients diagnosed with stage IA1 with lymphovascular space invasion(LVSI+),IA2 and IB1(International Federation of Gynecology and Obstetrics,FIGO 2009)cervical cancer from December 2012 to March 2018 in our department of gynaecology were retrospectively collected.All patients underwent MIS and were performed by gynecological oncologists in the same medical team with rich experience in MIS,and the tumur-free principles were strictly followed during surgeries.The disease-free survival(DFS)and overall survival(OS)were calculated by the Kaplan-Meier method.Univariate and multivariate analyses of survival and recurrence were performed using Cox risk proportional models.Results: A total of 185 patients were managed in the study,the median follow-up time was 51(rang,36-99)months,with the five-year DFS rate of97.0%(95%CI,93.97%-98.53%)and the five-year OS rate of 97.8%(95%CI,95.93%-98.56%).Among them,six(3.24%)patients relapsed and four(2.16%)of whom died.In the univariate analysis,squamous cell carcinoma was associated with higher DFS and OS.In the multivariate analysis,no specific risk factors were independently related to DFS and OS,which may be due to the fewer recurrence and death cases in this study.Conclusion: For MIS,the actual proficiency levels of surgeons and tumur-free principles may play vital roles in affecting the oncological outcomes of cancer patients.Histologic cell type also be an important factor affecting survival outcomes.However,more prospective randomized controlled studies are required to corroborate the safety and feasibility of MIS in cervical cancer treatment. |
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