The Impact of Surgical Practice on Oncological Outcomes in Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer, Spanish National Registry
This study aimed to assess whether surgical practice had a significant impact on oncological outcomes among women who underwent robot-assisted radical hysterectomy for early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009). The secondary objective was to audit the pre-surgical quality indicators (QI)...
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| Veröffentlicht in: | Cancers 2022-01, Vol.14 (3), p.698 |
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| creator | Fernandez-Gonzalez, Sergi Ponce, Jordi Martínez-Maestre, María Ángeles Barahona, Marc Gómez-Hidalgo, Natalia R Díaz-Feijoo, Berta Casajuana, Andrea Gracia, Myriam Frias-Gomez, Jon Benavente, Yolanda Costas, Laura Martí, Lola Melero, Lidia Silvan, Jose Manuel Beiro, Eva Lobo, Ignacio De la Rosa, Jesús Coronado, Pluvio J Gil-Moreno, Antonio |
| description | This study aimed to assess whether surgical practice had a significant impact on oncological outcomes among women who underwent robot-assisted radical hysterectomy for early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009). The secondary objective was to audit the pre-surgical quality indicators (QI) proposed by the European Society of Gynaecological Oncology (ESGO). The top 5 of 10 centers in Spain and Portugal were included in the analysis. The hospitals were divided into group A (
= 118) and group B (
= 97), with recurrence rates of 10%, respectively. After balancing both groups using the propensity score, the ORs for all events were higher and statistically significant for group B (recurrences OR = 1.23, 95% CI = 1.13-1.15,
-value = 0.001; death OR = 1.10, 95% CI = 1.02-1.18,
-value = 0.012; disease-specific mortality OR
= 1.11, 95% CI = 1.04-1.19,
-value = 0.002). A higher surgical volume, higher participation in clinical trials, higher rate of MRI use for diagnosis, greater use of sentinel lymph node biopsies, and a favorable learning curve with low rates of early recurrences were observed among the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes not only after robot-assisted surgery, but also after laparoscopies and open surgeries in the treatment of cervical cancer. |
| doi_str_mv | 10.3390/cancers14030698 |
| format | Article |
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= 118) and group B (
= 97), with recurrence rates of <10% and >10%, respectively. After balancing both groups using the propensity score, the ORs for all events were higher and statistically significant for group B (recurrences OR = 1.23, 95% CI = 1.13-1.15,
-value = 0.001; death OR = 1.10, 95% CI = 1.02-1.18,
-value = 0.012; disease-specific mortality OR
= 1.11, 95% CI = 1.04-1.19,
-value = 0.002). A higher surgical volume, higher participation in clinical trials, higher rate of MRI use for diagnosis, greater use of sentinel lymph node biopsies, and a favorable learning curve with low rates of early recurrences were observed among the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes not only after robot-assisted surgery, but also after laparoscopies and open surgeries in the treatment of cervical cancer.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers14030698</identifier><identifier>PMID: 35158966</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Audits ; Biopsy ; Body mass index ; Cancer therapies ; Cervical cancer ; Clinical trials ; Diagnosis ; Histology ; Hospitals ; Hysterectomy ; Invasiveness ; Lymph nodes ; Lymphatic system ; Magnetic resonance imaging ; Mortality ; Robotic surgery ; Statistical analysis ; Womens health</subject><ispartof>Cancers, 2022-01, Vol.14 (3), p.698</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-bb64f77e044c9fbfaf2d8987f3e5e913b6abce4af1b75fc017b4e9400ef798853</citedby><cites>FETCH-LOGICAL-c421t-bb64f77e044c9fbfaf2d8987f3e5e913b6abce4af1b75fc017b4e9400ef798853</cites><orcidid>0000-0002-3049-1790 ; 0000-0003-0357-2015 ; 0000-0003-2755-302X ; 0000-0002-9969-5628 ; 0000-0002-0613-2261</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833333/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833333/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35158966$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fernandez-Gonzalez, Sergi</creatorcontrib><creatorcontrib>Ponce, Jordi</creatorcontrib><creatorcontrib>Martínez-Maestre, María Ángeles</creatorcontrib><creatorcontrib>Barahona, Marc</creatorcontrib><creatorcontrib>Gómez-Hidalgo, Natalia R</creatorcontrib><creatorcontrib>Díaz-Feijoo, Berta</creatorcontrib><creatorcontrib>Casajuana, Andrea</creatorcontrib><creatorcontrib>Gracia, Myriam</creatorcontrib><creatorcontrib>Frias-Gomez, Jon</creatorcontrib><creatorcontrib>Benavente, Yolanda</creatorcontrib><creatorcontrib>Costas, Laura</creatorcontrib><creatorcontrib>Martí, Lola</creatorcontrib><creatorcontrib>Melero, Lidia</creatorcontrib><creatorcontrib>Silvan, Jose Manuel</creatorcontrib><creatorcontrib>Beiro, Eva</creatorcontrib><creatorcontrib>Lobo, Ignacio</creatorcontrib><creatorcontrib>De la Rosa, Jesús</creatorcontrib><creatorcontrib>Coronado, Pluvio J</creatorcontrib><creatorcontrib>Gil-Moreno, Antonio</creatorcontrib><title>The Impact of Surgical Practice on Oncological Outcomes in Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer, Spanish National Registry</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>This study aimed to assess whether surgical practice had a significant impact on oncological outcomes among women who underwent robot-assisted radical hysterectomy for early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009). The secondary objective was to audit the pre-surgical quality indicators (QI) proposed by the European Society of Gynaecological Oncology (ESGO). The top 5 of 10 centers in Spain and Portugal were included in the analysis. The hospitals were divided into group A (
= 118) and group B (
= 97), with recurrence rates of <10% and >10%, respectively. After balancing both groups using the propensity score, the ORs for all events were higher and statistically significant for group B (recurrences OR = 1.23, 95% CI = 1.13-1.15,
-value = 0.001; death OR = 1.10, 95% CI = 1.02-1.18,
-value = 0.012; disease-specific mortality OR
= 1.11, 95% CI = 1.04-1.19,
-value = 0.002). A higher surgical volume, higher participation in clinical trials, higher rate of MRI use for diagnosis, greater use of sentinel lymph node biopsies, and a favorable learning curve with low rates of early recurrences were observed among the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes not only after robot-assisted surgery, but also after laparoscopies and open surgeries in the treatment of cervical cancer.</description><subject>Audits</subject><subject>Biopsy</subject><subject>Body mass index</subject><subject>Cancer therapies</subject><subject>Cervical cancer</subject><subject>Clinical trials</subject><subject>Diagnosis</subject><subject>Histology</subject><subject>Hospitals</subject><subject>Hysterectomy</subject><subject>Invasiveness</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Magnetic resonance imaging</subject><subject>Mortality</subject><subject>Robotic surgery</subject><subject>Statistical analysis</subject><subject>Womens 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Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer, Spanish National Registry</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2022-01-29</date><risdate>2022</risdate><volume>14</volume><issue>3</issue><spage>698</spage><pages>698-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>This study aimed to assess whether surgical practice had a significant impact on oncological outcomes among women who underwent robot-assisted radical hysterectomy for early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009). The secondary objective was to audit the pre-surgical quality indicators (QI) proposed by the European Society of Gynaecological Oncology (ESGO). The top 5 of 10 centers in Spain and Portugal were included in the analysis. The hospitals were divided into group A (
= 118) and group B (
= 97), with recurrence rates of <10% and >10%, respectively. After balancing both groups using the propensity score, the ORs for all events were higher and statistically significant for group B (recurrences OR = 1.23, 95% CI = 1.13-1.15,
-value = 0.001; death OR = 1.10, 95% CI = 1.02-1.18,
-value = 0.012; disease-specific mortality OR
= 1.11, 95% CI = 1.04-1.19,
-value = 0.002). A higher surgical volume, higher participation in clinical trials, higher rate of MRI use for diagnosis, greater use of sentinel lymph node biopsies, and a favorable learning curve with low rates of early recurrences were observed among the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes not only after robot-assisted surgery, but also after laparoscopies and open surgeries in the treatment of cervical cancer.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>35158966</pmid><doi>10.3390/cancers14030698</doi><orcidid>https://orcid.org/0000-0002-3049-1790</orcidid><orcidid>https://orcid.org/0000-0003-0357-2015</orcidid><orcidid>https://orcid.org/0000-0003-2755-302X</orcidid><orcidid>https://orcid.org/0000-0002-9969-5628</orcidid><orcidid>https://orcid.org/0000-0002-0613-2261</orcidid><oa>free_for_read</oa></addata></record> |
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| source | PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Audits Biopsy Body mass index Cancer therapies Cervical cancer Clinical trials Diagnosis Histology Hospitals Hysterectomy Invasiveness Lymph nodes Lymphatic system Magnetic resonance imaging Mortality Robotic surgery Statistical analysis Womens health |
| title | The Impact of Surgical Practice on Oncological Outcomes in Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer, Spanish National Registry |
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