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Objective@#To compare survival outcomes between cervical adenocarcinoma (ADC) and squamous cell carcinoma (SCC) using a propensity score matching (PSM) analysis based on the Surveillance, Epidemiology, and End Results (SEER) Program. @*Methods@#Patients diagnosed with cervical cancer between 1998 and 2016 were identified from the SEER database. The Kaplan-Meier method and Cox regression analysis were used to analyze survival. A subgroup analysis of overall survival (OS) between patients with ADC and SCC was performed after the 1:1 PSM analysis. @*Results@#Of the 33,148 patients, 24,591 (79.19%) had SCC and 8,557 (25.81%) had ADC. In the unmatched cohort, after adjustment in multivariate analysis, patients with ADC had a worse prognosis than patients with SCC (hazard ratio [HR]=1.12; 95% confidence interval [CI]=1.07– 1.18; p<0.001). In the propensity matched cohort, Kaplan-Meier analysis and subgroup analysis showed that ADC was associated with a worse prognosis than SCC (p=0.001). An analysis stratified by SEER stage revealed a worse prognosis for patients with ADC patients presenting with a regional disease than patients with SCC (HR=1.24; 95% CI=1.14–1.36 p<0.001), but no statistically significant differences were observed between the localized disease (HR=0.97; 95% CI=0.86–1.10; p=0.664) and distant disease (HR=1.09; 95% CI=0.97–1.22; p=0.162) subgroups. @*Conclusion@#The significant differences in survival outcomes between patients with cervical ADC and SCC were only observed in the regional disease subgroup, but not in the localized disease and distant disease subgroups.
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Objective@#To compare survival outcomes between cervical adenocarcinoma (ADC) and squamous cell carcinoma (SCC) using a propensity score matching (PSM) analysis based on the Surveillance, Epidemiology, and End Results (SEER) Program. @*Methods@#Patients diagnosed with cervical cancer between 1998 and 2016 were identified from the SEER database. The Kaplan-Meier method and Cox regression analysis were used to analyze survival. A subgroup analysis of overall survival (OS) between patients with ADC and SCC was performed after the 1:1 PSM analysis. @*Results@#Of the 33,148 patients, 24,591 (79.19%) had SCC and 8,557 (25.81%) had ADC. In the unmatched cohort, after adjustment in multivariate analysis, patients with ADC had a worse prognosis than patients with SCC (hazard ratio [HR]=1.12; 95% confidence interval [CI]=1.07– 1.18; p<0.001). In the propensity matched cohort, Kaplan-Meier analysis and subgroup analysis showed that ADC was associated with a worse prognosis than SCC (p=0.001). An analysis stratified by SEER stage revealed a worse prognosis for patients with ADC patients presenting with a regional disease than patients with SCC (HR=1.24; 95% CI=1.14–1.36 p<0.001), but no statistically significant differences were observed between the localized disease (HR=0.97; 95% CI=0.86–1.10; p=0.664) and distant disease (HR=1.09; 95% CI=0.97–1.22; p=0.162) subgroups. @*Conclusion@#The significant differences in survival outcomes between patients with cervical ADC and SCC were only observed in the regional disease subgroup, but not in the localized disease and distant disease subgroups.
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Objective To explore the accuracy of hysteroscopy as a diagnosis for endometrial carcinoma and to determine if the procedure increase the rate of positive peritoneal cytology in the patients. Methods The peritoneal cytology of 36 patients with endometrial carcinoma diagnosed by D&C or hysteroscopy was retrospectively analyzed. Results The peritoneal cytology was positive in 1 (5.9%) of the 17 cases diagnosed by D&C and 2 (10.5%) of the 19 cases diagnosed by hysteroscopy (P=1.000). Based on the pathological examination,the accuracy of D&C was 52.9% (9/17),which was significantly lower than that of hysteroscopy [89.5% (17/19),P=0.025]. In the cases with stage Ⅰ endometrial carcinoma,the diagnostic accordance rate of hysteroscopy was 85.7% (12/14),while that of the D&C was 42.9% (6/14,P=0.040). The 36 patients were followed up for 2 months to 4 and a half year (over 1 year in 28 cases). One patient with Ⅲc stage carcinoma died of recurrent tumor in 2 years after the treatment. Conclusion Hysteroscopy shows higher diagnosis accuracy with no evidence indicating an increased rate of positive peritoneal cytology compared to D&C.
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0.05). The mean operation time of the LAVH group was significantly shorter than that of the TLH group [(95.6?18.2) minutes vs (112.9?24.5) minutes, t=-4.883, P=0.000]; whereas, the blood loss in the LAVH group was significantly more than the TLH group [(73.8?50.8) ml vs (49.8?26.9) ml, t=2.926, P=0.004]. Conclusions Laparoscopic hysterectomy is safe and feasible. Both LAVH and TLH have advantages. TLH is more suitable to experienced doctors.