DataSheet_1_Comparison of Laparoscopic and Open Surgery for Women With Early-Stage Epithelial Ovarian Cancer.docx

ObjectiveThis study evaluated the oncologic outcomes of laparoscopy and laparotomy in the management of early-stage ovarian cancer patients.
MethodsWe conducted an observational study of women diagnosed with International Federation of Gynecology and Obstetrics (FIGO) 2014 stage I ovarian cancer who underwent surgery at the West China Second University Hospital from 2012 to 2020. Patients who received adjuvant chemotherapy before surgery, those with non-epithelial histopathological types, or those with insufficient data were excluded. Using propensity score matching, data from consecutive laparoscopic patients treated by laparoscopy were matched 1:2 with a cohort of patients undergoing open surgery. The operative and survival outcomes among the matched cohorts were examined using the Kaplan–Meier method.
ResultsAmong 200 eligible patients, 74 patients undergoing laparoscopy were compared with a cohort of 126 patients undergoing open surgery. Baseline characteristics were similar between groups after matching. Patients who had laparoscopy had a shorter operative time (P = 0.001), a shorter hospital stay (P <0.001), and lower blood loss (P = 0.001) than patients who had open surgery. The median (range) follow-up period was 43.0 (38.8–47.2) and 45.0 (36.0–54.0) months for cases and controls, respectively (P <0.001). There are no significant differences in progression-free survival (P = 0.430, log-rank test) and overall survival (P = 0.067, log-rank test) between the two groups.
ConclusionsThere is no difference in prognosis between laparoscopic and open surgery in women with stage I epithelial ovarian cancer. Laparoscopic treatment of early-stage ovarian cancer is safe and feasible for stage I epithelial ovarian cancer patients.

研究目的 本研究评估腹腔镜手术与开腹手术治疗早期卵巢癌患者的肿瘤学结局。
研究方法 本研究为观察性研究，纳入2012年至2020年于华西第二医院接受手术治疗、经国际妇产科联盟（International Federation of Gynecology and Obstetrics, FIGO）2014版分期为I期的卵巢癌女性患者。排除术前接受辅助化疗、非上皮性组织病理学类型或临床资料不完整的患者。采用倾向得分匹配法，以1:2的比例将连续收治的腹腔镜手术患者队列与开腹手术患者队列进行匹配。采用卡普兰-迈耶法分析匹配后队列的手术及生存结局。
研究结果 本研究共纳入200例符合条件的患者，其中74例接受腹腔镜手术，126例接受开腹手术。匹配后两组患者的基线特征具有可比性。与开腹手术患者相比，腹腔镜手术患者的手术时长更短（P=0.001）、住院时间更短（P<0.001）、失血量更少（P=0.001）。腹腔镜组与开腹组的中位（范围）随访时间分别为43.0（38.8~47.2）个月与45.0（36.0~54.0）个月（P<0.001）。两组患者的无进展生存期（对数秩检验，P=0.430）与总生存期（对数秩检验，P=0.067）均无显著差异。
研究结论 对于I期上皮性卵巢癌（epithelial ovarian cancer）女性患者，腹腔镜手术与开腹手术的预后无显著差异。腹腔镜手术用于早期卵巢癌治疗对I期上皮性卵巢癌患者而言安全且可行。