Laparo-endoscopic single-site surgery vs conventional laparoscopic surgery for endometrial cancer: A systematic review and meta-analysis.

OBJECTIVE: To systematically review and evaluate the safety, advantages and clinical application value of laparo-endoscopic single-site surgery (LESS) for endometrial cancer by comparing it with conventional laparoscopic surgery (CLS). METHODS: We conducted a systematic review of the published literature comparing LESS with CLS in the treatment of endometrial cancer. English databases including PubMed, Embase, Ovid, and the Cochrane Library and Chinese databases including Chinese National Knowledge Infrastructure, Wanfang and China Biology Medicine were searched for eligible observational studies up to July 10, 2019. We then evaluated the quality of the selected comparative studies before performing a meta-analysis using the RevMan 5.3 software. The complications, surgical time, blood loss during surgery, postoperative length of hospital stay and number of lymph nodes removed during surgery were compared between the 2 surgical approaches. RESULTS: Four studies with 234 patients were finally included in this meta-analysis. We found that there was no statistically significant difference in complications between the 2 surgical approaches [odds ratio (OR): 0.63, 95% confidence interval (CI): 0.18-2.21, P = .47, I2 = 0%]. There was no statistically significant difference in blood loss between the 2 surgical approaches [mean difference (MD): -61.81, 95% CI: -130.87 to -7.25, P = .08, I2 = 74%]. There was no statistically significant difference in surgical time between the 2 surgical approaches (MD: -11.51, 95% CI: -40.19 to 17.16, P = .43, I2 = 81%). There was also no statistically significant difference in postoperative length of hospital stay between the 2 surgical approaches (MD: -0.56, 95% CI: -1.25 to -0.13, P = .11, I2 = 72%). Both pelvic and paraaortic lymph nodes can be removed with either of the 2 procedures. There were no statistically significant differences in the number of paraaortic lymph nodes and total lymph nodes removed during surgery between the 2 surgical approaches [(MD: -0.11, 95% CI: -3.12 to 2.91, P = .29, I2 = 11%) and (MD: -0.53, 95% CI (-3.22 to 2.16), P = .70, I2 = 83%)]. However, patients treated with LESS had more pelvic lymph nodes removed during surgery than those treated with CLS (MD: 3.33, 95% CI: 1.05-5.62, P = .004, I2 = 32%). CONCLUSION: Compared with CLS, LESS did not reduce the incidence of complications or shorten postoperative hospital stay. Nor did it increase surgical time or the amount of bleeding during surgery. LESS can remove lymph nodes and ease postoperative pain in the same way as CLS. However, LESS improves cosmesis by leaving a single small scar.

RIPK1 polymorphisms alter the susceptibility to cervical Cancer among the Uyghur population in China.

BACKGROUND: RIPK1 (receptor-interacting protein kinase-1) plays a role in cancer development, whereas no clear studies focused on the cervical cancer. The objective of this study was to evaluate the relationship between RIPK1 polymorphisms and cervical cancer risk among the Uyghur population. METHODS: We performed a case-control study including 342 cervical cancer patients and 498 age-matched healthy controls. Four RIPK1 genetic variants (rs6907943, rs2077681, rs9503400 and rs17548629) were genotyped with Agena MassARRAY platform. The associations between RIPK1 polymorphisms and cervical cancer risk were assessed under Binary logistic regression models. False discovery rate (FDR) was used to improve the results reliability. RESULTS: The results showed rs2077681 was significantly associated with cervical cancer risk under various genetic models (codominant: OR = 3.14, 95% CI = 1.40-7.07, p = 0.006, FDR-p = 0.018; recessive: OR = 3.20, 95% CI = 1.43-7.16, p = 0.005, FDR-0.018). The stratified analysis indicated that the relationships of rs6907946, rs9503400 and rs17548629 with cervical cancer risk were statistically significant in the subgroup of clinical stage (p < 0.05). CONCLUSION: Our findings demonstrated that RIPK1 polymorphisms were associated with cervical cancer susceptibility among the Uyghur population in China, and RIPK1 polymorphisms might be involved in the development of cervical cancer.