Analysis of prognosis and related influencing factors of different surgical approaches for early cervical cancer.
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OBJECTIVE: To evaluate the 5-year survival rates of patients with early cervical cancer (CC) under different surgical approaches and to analyze the factors affecting the prognosis of these patients. METHODS: A retrospective analysis and follow-up study were conducted on patients who underwent surgical treatment for early CC at Guangdong Women and Children Hospital between January 2005 and December 2017. Prognostic factors were analyzed using the Kaplan-Meier method and Cox regression model. RESULTS: A total of 726 patients were included, with 347 in the open surgery group and 379 in the laparoscopy group. The proportion of deep stromal infiltration in the open group was significantly higher than in the laparoscopy group (228/347 vs. 194/379, respectively; P < 0.05). Similarly, the tumor diameter (< 4 cm) was significantly larger in the open group compared to the laparoscopy group (51/347 vs. 26/379, respectively; P < 0.05). There were no statistically significant differences between the two groups in terms of the number of pregnancies, number of deliveries, menopause, contraceptive methods, high-risk HPV infection, clinical stage, pathological type, degree of differentiation, parametrial invasion, or lymph node metastasis (P > 0.05). The mean follow-up period was 53.15 ± 15.33 months. The overall 5-year survival rate (OS) for all patients was 89.0%, while the disease-free survival rate (DFS) was 86.8%. The 5-year OS rates in the open and laparoscopy groups were 87.2% and 90.4%, respectively, while the 5-year DFS rates were 84.6% and 88.6%, respectively, with no statistically significant differences between the groups (P > 0.05). Multivariate analysis revealed that clinical stage, vascular invasion, and tumor diameter were independent risk factors affecting survival and prognosis in patients with CC. However, the surgical approach did not significantly influence prognosis. CONCLUSION: The 5-year overall survival rate of patients with early CC was 89.0%. Laparoscopic surgery did not adversely affect the prognosis of early CC patients. Both surgical approaches demonstrate favorable prospects for treating early CC. Prognosis in early CC is influenced by clinical stage, vascular invasion, and tumor diameter, rather than the surgical approach used.