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PubMed

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Radical hysterectomy in early cervical cancer in Europe: characteristics, outcomes and evaluation of ESGO quality indicators

International journal of gynecological cancer. 2021 Sep ; 31 (9) : 1212-1219. [epub] 20210728

Int J Gynecol Cancer
ISSN 1525-1438 | 1048-891X
Source

Language English Country United States Media print-electronic

Document type Journal Article

Persistent link https://www.medvik.cz/link/pmid34321289

PubMed 34321289
DOI 10.1136/ijgc-2021-002587
PII: S1048-891X(24)00465-1
Knihovny.cz E-resources

Keywords
SLN and lympadenectomy, cervical cancer, hysterectomy, postoperative complications, radiation,
MeSH
Hysterectomy methods MeSH
Middle Aged MeSH
Humans MeSH
Uterine Cervical Neoplasms surgery MeSH
Quality Indicators, Health Care standards MeSH
Treatment Outcome MeSH
Check Tag
Middle Aged MeSH
Humans MeSH
Female MeSH
Publication type
Journal Article MeSH
Geographicals
Europe MeSH

INTRODUCTION: Comprehensive updated information on cervical cancer surgical treatment in Europe is scarce. OBJECTIVE: To evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database. METHODS: The SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified. RESULTS: The mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0-84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation. CONCLUSIONS: In this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.

Amsterdam University Medical Centres Amsterdam Noord Holland Netherlands

Azienda Ospedaliero Universitaria di Bologna Policlinico SantOrsola Malpighi Bologna Italy

Bellvitge University Hospital L'Hospitalet de Llobregat Catalunya Spain

Clinic of Obstetrics and Gynecology Hospital San Gerardo Monza Italy

Clinica Universidad de Navarra Departamento de Ginecologia y Obstetricia Madrid Spain

Clinica Universidad de Navarra Departamento de Ginecologia y Obstetricia Pamplona Navarra Spain

Clinical Hospital Center Rijeka Rijeka Croatia

Clinical Hospital Center Zagreb Croatia

Department of Gynaecology LUMC Leiden Netherlands

Department of Gynecologíc Oncology Hospital Universitario La Paz Madrid Madrid Spain

Department of Gynecologic Oncology Saglik Bilimleri University Antalya Research and Training Hospital Antalya Turkey

Department of Gynecologic Oncology Universidad de Navarra Pamplona Navarra Spain