SLN and lympadenectomy; cervical cancer; hysterectomy; postoperative complications; radiation; Europe; Female; Humans; Hysterectomy/methods; Middle Aged; Quality Indicators, Health Care/standards; Treatment Outcome; Uterine Cervical Neoplasms/surgery; Quality Indicators, Health Care; Uterine Cervical Neoplasms; Oncology; Obstetrics and Gynecology
Abstract :
[en] [en] 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.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Boria, Felix ; Clinica Universidad de Navarra Departamento de Ginecologia y Obstetricia, Madrid, Spain
Chiva, Luis ; Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain lchiva@unav.es
Zanagnolo, Vanna; Istituto Europeo di Oncologia, Milano, Anognnn, Italy
Querleu, Denis ; Department of Surgery, Institut Bergonie, Bordeaux, France
Martin-Calvo, Nerea; Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
Căpîlna, Mihai Emil; Emergency County Hospital Targu-Mures, Targu Mures, Romania
Fagotti, Anna; Department of Woman, Child, and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
Kucukmetin, Ali; Queen Elizabeth Hospital, Gateshead, Gateshead, UK
Mom, Constantijne; Amsterdam University Medical Centres, Amsterdam, Noord-Holland, Netherlands
Chakalova, Galina; University Oncologic Hospital, Sofia, Bulgaria
Shamistan, Aliyev; National Center of Oncology, Baku, Azerbaijan
Malzoni, Mario; Endoscopica Malzoni, Center for Advanced Endoscopic Gynecologic Surgery, Center for Advanced Endoscopic Gynecologic Surgery, Avellino, Italy
Narducci, Fabrice; Department of Gynecology, Centre Oscar Lambret, Lille, France
Arencibia, Octavio; University Maternal Hospital Canary Islands, Las Palma, Spain
Raspagliesi, Francesco; Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
Toptas, Tayfun ; Department of Gynecologic Oncology, Saglik Bilimleri University Antalya Research and Training Hospital, Antalya, Turkey
Cibula, David; Department of Obstetrics and Gynecology, University of Prague, Prague, Czech Republic
Meydanli, Mehmet Mutlu ; Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
Tavares, Mariana; Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
Golub, Dmytro; Department of Surgery, LISOD - Israeli Oncological Hospital, Kyiv region, Ukraine
Perrone, Anna Myriam ; Azienda Ospedaliero-Universitaria di Bologna Policlinico SantOrsola-Malpighi, Bologna, Italy
Poka, Robert ; Obstetrics and Gynecology, Unit of Gynecologic Oncology, Institute of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
Tsolakidis, Dimitrios; General Hospital of Thessaloniki Papageorgiou, Thessaloniki, Central Macedonia, Greece
Vujić, Goran; Clinical Hospital Center, Zagreb, Croatia
Jedryka, Marcin A ; Department of Oncological Gynecology, Uniwersytet Medyczny im Piastów Śląskich we Wrocławiu (Wroclaw Medical University), Wroclaw, Poland
Zusterzeel, Petra L M; Department of Gynecological Oncology, Radboudumc, Nijmegen, Netherlands
Beltman, Jogchum Jan; Department of Gynaecology, LUMC, Leiden, Netherlands
Goffin, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)
Haidopoulos, Dimitrios; Division of Gynecologic Oncology, 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
Haller, Herman; Clinical Hospital Center Rijeka, Rijeka, Croatia
Jach, Robert; Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland
Yezhova, Iryna; Lviv Oncology Center, Lviv, Ukraine
Berlev, Igor; North-Western State Medical University. N.N. Petrov Research Institute of Oncology, Saint-Petersburg, Saint-Petersburg, Russian Federation
Bernardino, Margarida; Department of Gynecology, Instituto Português de Oncologia de Lisboa, Lisboa, Lisboa, Portugal
Bharathan, Rasiah; University Hospitals of Leicester NHS Trust, Leicester, Leicester, UK
Lanner, Maximilian; Kardinal Schwarzenberg'sches Krankenhaus, Schwarzach, Steiermark, Austria
Maenpaa, Minna M; Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
Sukhin, Vladyslav ; Department of Oncology, Radiology and Radiation Medicine, V N Karazin Kharkiv National University, Harkiv, Ukraine ; Department of Oncogynecology, Grigoriev Institute for Medical Radiology NAMS of Ukraine, Harkiv, Ukraine
Feron, Jean-Guillaume; Institut Curie, Paris, Île-de-France, France
Fruscio, Robert ; Department of Medicine and Surgery, University of Milan-Bicocca, Milano, Italy ; Clinic of Obstetrics and Gynecology, Hospital San Gerardo, Monza, Italy
Kukk, Kersti; North Estonia Medical Centre, Tallinn, Estonia
Ponce, Jordi; Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalunya, Spain
Alonso-Espías, María; Department of Gynecologíc Oncology, Hospital Universitario La Paz, Madrid, Madrid, Spain
Minguez, Jose Angel; Department of Gynecology, Clinica Universitaria de Navarra, Pamplona, Navarra, Spain
Vázquez-Vicente, Daniel ; Department of Gynecology, Clinica Universitaria de Navarra, Madrid, Spain
Manzour, Nabil ; Clinica Universidad de Navarra Departamento de Ginecologia y Obstetricia, Pamplona, Navarra, Spain
Jurado, Matias; Department of Gynecology, Clinica Universitaria de Navarra, Pamplona, Navarra, Spain
Castellanos, Teresa; Department of Gynecology, Clinica Universitaria de Navarra, Madrid, Spain
Chacon, Enrique ; Department of Gynecologic Oncology, Universidad de Navarra, Pamplona, Navarra, Spain
Alcazar, Juan Luis ; Department of Obstetrics and Gynecology, School of Medicine, University of Navarra, Pamplona, Spain
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