子宫内膜癌是常见的妇科恶性肿瘤,其发病与肥胖、无孕激素抵抗的雌激素长期刺激有关。手术是 治疗子宫内膜癌的主要方式。手术范围包括全子宫、双附件切除,以及系统性盆腔及腹主动脉旁淋巴结切除或前哨 淋巴结活检术。当病灶局限于宫体时,微创手术是优先考虑的途径。由于固有的技术特点,机器人手术系统在子宫 内膜癌手术中能够体现出比传统术式较明显的优势,并已经广泛应用于子宫内膜癌的手术治疗中。
Endometrial cancer is a common gynecological malignancy and associated with obesity and long-term estrogen usage without progesterone. Surgery is the mainstay of the initial management of endometrial cancer. The current surgical approach includes removal of uterus, cervix, fallopian tubes, ovaries and systematic pelvic and paraaortic lymphadenectomy or sentinel lymph node biopsy. Minimally invasive surgery is the preferred approach when the lesion is confined to the uterus. With the intrinsic characteristics and advantages over traditional surgical approaches, robotic surgical system has been widely applied into surgical treatment on endometrial cancer.
收稿日期:2021-10-08 录用日期:2022-02-25
Received Date: 2021-10-08 Accepted Date: 2022-02-25
基金项目:广西科技计划项目重点研发计划(AB17195003);广西青年科学基金(2020JJB140152);广西医疗卫生适宜技术 开发与推广应用项目(S2019103)
Foundation Item: Key Research and Development Program of GuangXi Science and Technology Plan (AB17195003); Youth Science Foundation of Guangxi (2020JJB140152); Health Appropriate Technology Development and Promotion Project of Guangxi (S2019103)
通讯作者:范江涛,Email:jiangtao_fan1969@163.com;阳志军,Email:yzj7528@126.com Corresponding Author: FAN Jiangtao, Email: jiangtao_fan1969@163.com; YANG Zhijun, Email: yzj7528@126.com
引用格式:中国医师协会微无创医学专业委员会妇科肿瘤专委会 . 机器人手术治疗子宫内膜癌中国专家共识(2021 版)[J]. 机器 人外科学杂志(中英文),2022,3(5):414-422.
Citation: Gynecologic Oncology Group of Minimally Invasive and Noninvasive Medicine Committee of CMDA. Chinese expert consensus on robotic surgery for endometrial cancer (2021) [J]. Chinese Journal of Robotic Surgery, 2022, 3(5): 414-422.
[1] Henley S J, Ward E M, Scott S, et al. Annual report to the nation on the status of cancer. I. National cancer statistics[J]. Cancer, 2020, 126(10): 2225-2249.
[2] Lorter-Tieulent J, Ferlay J, Bray F, et al. International patterns and trends in endometrial cancer incidence, 1978-2013[J]. J Nat Cancer Inst, 2018, 110(4): 354-361.
[3] Sung H, Ferlay J, Siegel R L, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
[4] Lauby-Secretan B, Scoccianti C, Loomis D, et al. Body fatness and cancer-viewpoint of the IARC Working Group[J]. N Engl J Med, 2016, 357(8): 794-798.
[5] Saed L, Varse F, Baradaran H R, et al. The effect of diabetes on the risk of endometrial cancer: an updated a systematic review and meta-analysis[J]. BMC Cancer, 2019, 19(1): 527.
[6] Renehan A G, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies[J]. Lancet, 2008, 371(9612): 569-578.
[7] Ryan N A J, Morris J, Green K, et al. Association of mismatch repair mutation with age at cancer onset in Lynch syndrome: implications for stratified surveillance strategies[J]. JAMA Oncol, 2017, 3(12): 1702-1706.
[8] 中国抗癌协会妇科肿瘤专业委员会 . 子宫内膜癌诊 断与治疗指南 (2021 年版 )[J]. 中国癌症杂志 , 2021, 3(6): 501-512.
[9] Walker J L, Piedmonte M R, Spirtos N M, et al. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2[J]. J Clin Oncol, 2009, 27(32): 5331-5336.
[10] Scalici J, Laughlin B B, Finan M A, et al. The trend towards minimally invasive surgery (MIS) for endometrial cancer: an ACS NSQIP evaluation of surgical outcomes[J]. Gynecol Oncol, 2015, 136(3): 512-515.
[11] Fader A N, Weise R M, Sinno A K, et al. Utilization of minimally invasive surgery in endometrial cancer care: a quality and cost disparity[J]. Ostet Gynecol, 2016, 127(1): 91-100. [12] Mannschreck D, Weise R M, Dowdy S C, et al. Disparities in surgical care among women with endometrial cancer[J]. Obstet Gynecol, 2016, 128(3): 526-534.
[13] Stewart K I, Fader A N. New developments in minimally invasive gynecologic oncology surgery[J]. Clin Obstet Gynecol, 2017, 60(2): 330-348.
[14] Mahdi H, Jernigan A M, Ajebori Q, et al. The impact of obesity on the 30-day morbidity and mortality after surgery for endometrial cancer[J]. J Minim Invasive Gynecol, 2015, 22(1): 94-102.
[15] Corrado G, Vizza E, Cela V, et al. Laparoscopic versus robotic hysterectomy in obese and extremely obese patients with endometrial cancer: a multi-institutional analysis[J]. Eur J Surg Oncol, 2018, 44(12): 1935-1941.
[16] Kilgore J E, Jackson A L, Ko E M, et al. Recurrencefree and 5-year survival following robotic-assisted surgical staging for endometrial carcinoma[J]. Gynecol Oncol, 2013, 129(1): 49-53.
[17] Rossi E C, Kowalski L D, Scalici J, et al. A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study[J]. Lancet Oncol, 2017, 18(3): 384-392.
[18] Carlson J W, Kauderer J, Hutson A, et al. GOG 244- the lymphedema and gynecologic cancer (LEG) study: incidence and risk factors in newly diagnosed patients[J]. Gynecol Oncol, 2020, 156(2): 467-474.
[19] Han G, Sidhu D, Duggan M A, et al. Reproducibility of histological cell type in high-grade endometrial carcinoma[J]. Mod Pathol, 2013, 26(12): 1594-1604.
[20] The Cancer Genome Atlas Research Network, Kandoth C, Schultz N, et al. Integrated genomic characterization of endometrial carcinoma[J]. Nature, 2013, 497(7447): 67-73.
[21] Ortashi O, Jain S, Emannuel O, et al. Evaluation of the sensitivity, specificity, positive and negative predictive values of preoperative magnetic resonance imaging for staging endometrial cancer. A prospective study of 100 cases at the Dorset Cancer Centre[J]. Eur J Obstet Gynecol Reprod Biol, 2008, 137(2): 232-235.
[22] American College of Obstetricians and Gynecologists. Committee opinion no. 628: robotic surgery in gynecology [J]. Obstet Gynecol, 2015, 125(3): 760-767.
[23] Lim P C, Kang E, Park D H. A comparative detail analysis of learning curve and surgical outcome for robotic hysterectomy with lymphadenectomy versus laparoscopic hysterectomy with lymphadenectomy in treatment of endometrial cancer: a case-matched controlled study of first one hundred twenty two patients[J]. Gynecol Oncol, 2011, 120(3): 413-418.
[24] 黄小冰 , 范江涛 , 陈红燕 , 等 . 机器人与腹腔镜手 术治疗子宫内膜癌的对比研究 [J]. 中国现代医学杂 志 , 2019, 29(4): 48-52.