达芬奇机器人手术系统应用于1142例宫颈癌患者的肿瘤结局分析  

Oncology outcomes of Da Vinci robot-assisted radical hysterectomy for 1142 cases of cervical cancer

作　　者：吕小慧 翟梁好 董健 周福兴 荆茹 陈必良 LYU Xiaohui;ZHAI Lianghao;DONG Jian;ZHOU Fuxing;JING Ru;CHEN Biliang(Department of Obstetrics and Gynecology,Xijing Hospital,Air Force Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学西京医院妇产科,陕西西安710032

出　　处：《机器人外科学杂志（中英文）》2023年第5期389-396,共8页Chinese Journal of Robotic Surgery

基　　金：国家自然科学基金(82002740)。

摘　　要：目的:探讨达芬奇机器人手术系统应用于宫颈癌患者手术治疗后对其肿瘤结局的影响。方法:选取2013年3月—2018年3月在空军军医大学西京医院妇产科行达芬奇机器人辅助腹腔镜下宫颈癌根治术的1142例患者临床资料。回顾性分析临床病理资料、术后辅助治疗、复发率,并用Kaplan-Meier计算患者的无病生存期(Disease-free Survival,DFS)及总生存期(Overall Survival,OS)。结果:本研究共纳入1142例患者,早期患者(ⅠA2~ⅠB1期)691例,晚期患者(ⅠB2~ⅡB期)451例,中位随访时间70.9个月,失访72例(6.30%),随访率为93.70%。早期患者中,复发78例(11.29%),死亡59例(8.54%),3年OS 96.7%,DFS 93.2%;5年OS 95.3%,DFS 91.9%。晚期患者中,复发135例(29.93%),死亡120例(26.61%),3年OS 85.1%,DFS 79.2%;5年OS 82.3%,DFS 77.2%。结论:本次单中心、回顾性研究结果表明,达芬奇机器人手术系统可有选择性地应用于早期宫颈癌患者,但需要改善手术相关措施,进一步评估其对肿瘤结局的影响。Objective:To investigate the clinical efficacy of Da Vinci robotic surgical system in treating patients with cervical cancer.Methods:The clinical data of patients who underwent Da Vinci robot-assisted radical hysterectomy in Xijing Hospital of Air Force Military Medical University from March 2013 to March 2018 were selected.The pathological data,postoperative adjuvant therapy and recurrence rate were analyzed retrospectively.The disease-free survival(DFS)and overall survival(OS)of patients were calculated by Kaplan-Meier.Results:A total of 1142 patients were selected into this study,including 691 patients in early stage(ⅠA2-ⅠB1)and 451 patients in advanced stage(ⅠB2-ⅡB).The median follow-up time was 70.9 months,and 72 patients(6.30%)were lost to follow-up,with a follow-up rate of 93.70%.In early stage of cervical cancer,78 cases(11.29%)relapsed,59 cases(8.54%)died with the 3-year OS of 96.7%,3-year DFS of 93.2%,5-year OS of 95.3%,and 5-year DFS of 91.9%.Among the patients with advanced cervical cancer,135 cases(29.93%)relapsed,120 cases(26.61%)died,with the 3-year OS of 85.1%,3-year DFS of 79.2%,5-year OS of 82.3%,and 5-year DFS of 77.2%.Conclusion:This single-center,retrospective observational study found that the Da Vinci robotic surgical system could be selectively applied to early cervical cancer.However,its effect on the outcome of cervical cancer should be further evaluated by improving surgical measures.

关 键 词：宫颈癌 广泛性全子宫切除术 机器人手术系统 微创手术 

分 类 号：R737.33[医药卫生—肿瘤]