为了评估早期宫颈癌患者的单纯子宫切除术和淋巴结分期与根治性子宫切除术和淋巴结分期对总生存率的影响。我们对国家癌症数据库中诊断为早期宫颈癌的患者进行了一项回顾性队列研究。 2010年至2019年期间，直径为2厘米或更小（IA1期，通过IIA1，国际妇产科联合会分期，有淋巴管间隙侵犯）。经过1:1倾向评分匹配，我们比较了接受单纯子宫切除术和淋巴结分期的患者与接受根治性子宫切除术的患者。子宫切除术并进行淋巴结分期。用于匹配的变量包括年龄、肿瘤大小、种族和民族、淋巴管间隙侵犯、诊断年份、Charlson-Deyo 合并症评分、组织学和手术方法。主要结局是随访结束时的总生存率。次要结局包括30天再入院率以及30天和90天死亡率。总共有4,167名患者符合纳入标准，其中2,637名患者（63.3%）接受了根治性子宫切除术和淋巴结分期，1,530名患者（36.7%）接受了根治性子宫切除术和淋巴结分期。接受了简单的子宫切除术和淋巴结分期。经过倾向评分匹配后，每组均纳入 1,529 名患者。接受单纯子宫切除术的患者与接受根治性子宫切除术的患者的总生存率没有统计学差异（风险比1.25，95% CI，0.91-1.73，P=.17）。根据组织学、淋巴管间隙侵犯、肿瘤大小和手术方法进行的亚组分析并未显示不同子宫切除类型的总生存率存在统计学显着差异。子宫切除术组在 30 天再入院率（4.6% vs 4.2%，P=.73）、30 天死亡率（0.1% vs 0%，P=.14）或 90 天死亡率方面也没有显着差异。率（0.1% vs 0.1%，P=.93）。低风险宫颈癌患者可以接受较少的根治性手术，而不会对肿瘤结果产生负面影响。版权所有 © 2024 美国妇产科学院。由 Wolters Kluwer Health, Inc. 出版。保留所有权利。

To assess the effect on overall survival of simple hysterectomy with lymph node staging compared with radical hysterectomy with lymph node staging for patients with early-stage cervical cancer.We conducted a retrospective cohort study of patients in the National Cancer Database diagnosed with early cervical carcinoma of 2 cm or smaller (stage IA1 with lymphovascular space invasion through IIA1, International Federation of Gynecology and Obstetrics staging) from 2010 to 2019. After 1:1 propensity score matching, we compared patients who underwent simple hysterectomy with lymph node staging and those with radical hysterectomy with lymph node staging. The variables used for matching were age, tumor size, race and ethnicity, lymphovascular space invasion, year of diagnosis, Charlson-Deyo comorbidity score, histology, and surgical approach. The primary outcome was overall survival at the end of follow-up. Secondary outcomes included 30-day readmission rate and 30- and 90-day mortality rates.In total, 4,167 patients met the inclusion criteria, of whom 2,637 patients (63.3%) underwent radical hysterectomy and lymph node staging and 1,530 patients (36.7%) underwent simple hysterectomy and lymph node staging. After propensity score matching, 1,529 patients in each group were included. There was no statistically significant difference in overall survival between patients who underwent simple hysterectomy and those who underwent radical hysterectomy (hazard ratio 1.25, 95% CI, 0.91-1.73, P=.17). Subgroup analysis by histology, lymphovascular space invasion, tumor size, and surgical approach did not reveal statistically significant differences in overall survival according to hysterectomy type. The hysterectomy groups also did not significantly differ in 30-day readmission rate (4.6% vs 4.2%, P=.73), 30-day mortality rate (0.1% vs 0%, P=.14), or 90-day mortality rate (0.1% vs 0.1%, P=.93).Patients with low-risk cervical cancer could undergo less radical surgery without a negative effect on their oncologic outcomes.Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.