The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National Registry

Minimal invasive surgery (MIS) has been associated with lower disease-free survival than open surgery among women who underwent radical hysterectomy for early-stage cervical cancer. However, the mechanisms by which MIS increases mortality in cervical cancer remain uncertain. We aimed to determine if...

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Authors: Fernández González, Sergi, Ponce i Sebastià, Jordi, Martínez-Maestre, María Ángeles, Barahona Orpinell, 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
Format: article
Status:Published version
Publication Date:2022
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/183991
Online Access:https://hdl.handle.net/2445/183991
Access Level:Open access
Keyword:Càncer ginecològic
Cirurgia ginecològica
Oncologia
Gynecologic cancer
Gynecologic surgery
Oncology
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spelling The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National RegistryFernández González, SergiPonce i Sebastià, JordiMartínez-Maestre, María ÁngelesBarahona Orpinell, MarcGómez-Hidalgo, Natalia R.Díaz Feijoo, BertaCasajuana, AndreaGracia, MyriamFrias Gomez, JonBenavente, YolandaCostas, LauraMartí, LolaMelero, LidiaSilvan, Jose ManuelBeiro, EvaLobo, IgnacioDe la Rosa, JesúsCoronado, Pluvio J.Gil Moreno, AntonioCàncer ginecològicCirurgia ginecològicaOncologiaGynecologic cancerGynecologic surgeryOncologyMinimal invasive surgery (MIS) has been associated with lower disease-free survival than open surgery among women who underwent radical hysterectomy for early-stage cervical cancer. However, the mechanisms by which MIS increases mortality in cervical cancer remain uncertain. We aimed to determine if surgical practice among centers using robotic surgery has an impact on oncological outcomes. We evaluated 215 women with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) who underwent robot-assisted radical hysterectomy in five Spanish tertiary centers between 2009 and 2018. 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 for the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes in all surgical approaches. 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 (n = 118) and group B (n = 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, p-value = 0.001; death OR = 1.10, 95% CI = 1.02-1.18, p-value = 0.012; disease-specific mortality ORr = 1.11, 95% CI = 1.04-1.19, p-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.MDPI2022202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion12 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/183991Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3390/cancers14030698Cancers, 2022, vol. 14, p. 698https://doi.org/10.3390/cancers14030698cc-by (c) Fernandez-Gonzalez, Sergi et al., 2022https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1839912026-05-29T05:05:01Z
dc.title.none.fl_str_mv The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National Registry
title The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National Registry
spellingShingle The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National Registry
Fernández González, Sergi
Càncer ginecològic
Cirurgia ginecològica
Oncologia
Gynecologic cancer
Gynecologic surgery
Oncology
title_short The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National Registry
title_full The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National Registry
title_fullStr The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National Registry
title_full_unstemmed The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National Registry
title_sort The impact of surgical practice on oncological outcomes in robot-assisted radical hysterectomy for early-stage cervical cancer, Spanish National Registry
dc.creator.none.fl_str_mv Fernández González, Sergi
Ponce i Sebastià, Jordi
Martínez-Maestre, María Ángeles
Barahona Orpinell, 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
author Fernández González, Sergi
author_facet Fernández González, Sergi
Ponce i Sebastià, Jordi
Martínez-Maestre, María Ángeles
Barahona Orpinell, 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
author_role author
author2 Ponce i Sebastià, Jordi
Martínez-Maestre, María Ángeles
Barahona Orpinell, 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
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Càncer ginecològic
Cirurgia ginecològica
Oncologia
Gynecologic cancer
Gynecologic surgery
Oncology
topic Càncer ginecològic
Cirurgia ginecològica
Oncologia
Gynecologic cancer
Gynecologic surgery
Oncology
description Minimal invasive surgery (MIS) has been associated with lower disease-free survival than open surgery among women who underwent radical hysterectomy for early-stage cervical cancer. However, the mechanisms by which MIS increases mortality in cervical cancer remain uncertain. We aimed to determine if surgical practice among centers using robotic surgery has an impact on oncological outcomes. We evaluated 215 women with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) who underwent robot-assisted radical hysterectomy in five Spanish tertiary centers between 2009 and 2018. 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 for the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes in all surgical approaches. 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 (n = 118) and group B (n = 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, p-value = 0.001; death OR = 1.10, 95% CI = 1.02-1.18, p-value = 0.012; disease-specific mortality ORr = 1.11, 95% CI = 1.04-1.19, p-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.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/183991
url https://hdl.handle.net/2445/183991
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3390/cancers14030698
Cancers, 2022, vol. 14, p. 698
https://doi.org/10.3390/cancers14030698
dc.rights.none.fl_str_mv cc-by (c) Fernandez-Gonzalez, Sergi et al., 2022
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Fernandez-Gonzalez, Sergi et al., 2022
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 12 p.
application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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