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RISS 인기검색어
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- 저자 : Chirag A. Shah (검색결과 2 건)
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Chirag A. Shah,Tiffany Beck,John B. Liao,Nadia V. Giannakopoulos,Dan Veljovich,Pam Paley 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.6
Objective: The use of robotic radical hysterectomy has greatly increased in the treatment of early stage cervical cancer. We sought to compare surgical and oncologic outcomes of women undergoing robotic radical hysterectomy compared to open radical hysterectomy. Methods: The clinic-pathologic, treatment, and recurrence data were abstracted through an Institutional Review Board-approved protocol at 2 separate large tertiary care centers in Seattle, Swedish Medical Center and the University of Washington. Data were collected from 2001–2012. Comparisons between the robotic and open cohorts were made for complications, recurrence, progression-free survival (PFS), and overall survival (OS). Results: In the study period, 109 robotic radical hysterectomies were performed. These were compared to 202 open radical hysterectomies. The groups were comparable in terms of age and body mass index (BMI). Length of stay (LOS) was considerably shorter in the robotic group (42.7 vs. 112.6 hours, p<0.001) as was estimated blood loss (EBL; 105.9 vs. 482.6 mL, p<0.001). There were more complications in the open radical hysterectomy group, 23.4% vs. 9.2% in the robotic group (p=0.002). The recurrence rate was comparable between the groups (10.1% vs. 10.4%, p=0.730). In multivariate adjusted analysis, robotic surgery was not a statistically significant predictor of PFS (p=0.230) or OS (0.85). Conclusion: Our study, one of the largest multi-institution cohorts of patients undergoing robotic radical hysterectomy, suggest robotic radical hysterectomy leads to comparable oncologic outcomes in the treatment of early stage cervical cancer with improved short-term surgical outcomes such as decreased LOS and EBL.
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Tilley Jenkins Vogel,Abhay Knickerbocker,Chirag A. Shah,Melissa A. Schiff,Christina Isacson,Rochelle L. Garcia,Barbara A. Goff 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.1
Objective: Despite the rarity of uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC), theycontribute disproportionately to endometrial cancer deaths. Sufficient clinical information regarding treatment and prognosis islacking. The aim of this study is to evaluate treatment outcomes in a rare cancer cohort based on the experience at two tertiarycare cancer centers. Methods: Clinicopathologic data were retrospectively collected on 279 patients with UPSC and UCCC treated between 1995 to2011. Mode of surgery, use of adjuvant treatment, and dissection of paraaoritc lymph nodes were evaluated for their associationwith overall survival (OS) and progression-free survival (PFS). Results: 40.9% of patients presented with stage I disease, 6.8% of patients presented with stage II disease and 52.3% of patientspresented with stages III and IV. Median follow-up was 31 months (range, 1 to 194 months). OS and PFS at 5 years were 63.0%and 51.9%, respectively. OS and PFS were not affected by mode of surgery (open vs. robotic approach; OS: hazard ratio [HR], 0.68;95% confidence interval [CI], 0.28 to 1.62; PFS: HR, 0.78; 95% CI, 0.40 to 1.56). Adjuvant treatment was associated with improvedOS in stages IB-II (HR, 0.14; 95% CI, 0.02 to 0.78; p=0.026) but not in stage IA disease. There was no difference in OS or PFS basedon the performance of a paraaoritc lymph node dissection. Conclusion: Minimally invasive surgical staging appears a reasonable strategy for patients with non-bulky UPSC and UCCC andwas not associated with diminished survival. Adjuvant treatment improved 5-year survival in stages IB-II disease.
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