Association between hospital surgical volume and perioperative outcomes of fertility-sparing trachelectomy for cervical cancer: A national study in the United States

Matsuo, Koji; Matsuzaki, Shinya; Mandelbaum, Rachel S.; Matsushima, Kazuhide; Klar, Maximilian; Grubbs, Brendan H.; Roman, Lynda D.; Wright, Jason D.

doi:10.1016/j.ygyno.2020.01.015

Cited by 16 publications

(9 citation statements)

References 36 publications

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“…Spontaneous regionalization of gynaecological malignancy procedures has occurred in the US. At the hospital level, Matsuo et al’s analysis showed that 89 centres that performed at least one trachelectomy for cervical cancer per year and only 6 centres met the criteria for top-decile centres in the United States [ 9 ]. The threshold of any RH to have a minimum trachelectomy volume of 1 case a year was 7.8 cases per year.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding cervical cancer, the current engagement literature is focused mostly on the effects of hospital volume on clinical outcomes, with less attention given to the effects of surgeon volume on perioperative outcomes. For patients with early-stage cervical cancer, surgery at highvolume centres is associated with lower reduced perioperative morbidity and improved survival, whereas for patients with locally advanced disease, hospital volume has a minimal impact on survival [9][10][11]. In addition to resources available at the hospital, the outcome of a surgical procedure may depend mainly on surgeon volume [12].…”

Section: Introductionmentioning

confidence: 99%

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Effect of annualized surgeon volume on major surgical complications for abdominal and laparoscopic radical hysterectomy for cervical cancer in China, 2004–2016: a retrospective cohort study

Liang

Liu

et al. 2023

BMC Women's Health

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Background Previous studies have suggested that higher surgeon volume leads to improved perioperative outcomes for oncologic surgery; however, the effect of surgeon volumes on surgical outcomes might differ according to the surgical approach used. This paper attempts to evaluate the effect of surgeon volume on complications or cervical cancer in an abdominal radical hysterectomy (ARH) cohort and laparoscopic radical hysterectomy (LRH) cohort. Methods We conducted a population-based retrospective study using the Major Surgical Complications of Cervical Cancer in China (MSCCCC) database to analyse patients who underwent radical hysterectomy (RH) from 2004 to 2016 at 42 hospitals. We estimated the annualized surgeon volumes in the ARH cohort and in the LRH cohort separately. The effect of the surgeon volume of ARH or LRH on surgical complications was examined using multivariable logistic regression models. Results In total, 22,684 patients who underwent RH for cervical cancer were identified. In the abdominal surgery cohort, the mean surgeon case volume increased from 2004 to 2013 (3.5 to 8.7 cases) and then decreased from 2013 to 2016 (8.7 to 4.9 cases). The mean surgeon case volume number of surgeons performing LRH increased from 1 to 12.1 cases between 2004 and 2016 (P < 0.01). In the abdominal surgery cohort, patients treated by intermediate-volume surgeons were more likely to experience postoperative complications (OR = 1.55, 95% CI = 1.11–2.15) than those treated by high-volume surgeons. In the laparoscopic surgery cohort, surgeon volume did not appear to influence the incidence of intraoperative or postoperative complications (P = 0.46; P = 0.13). Conclusions The performance of ARH by intermediate-volume surgeons is associated with an increased risk of postoperative complications. However, surgeon volume may have no effect on intraoperative or postoperative complications after LRH.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of annualized surgeon volume on major surgical complications for abdominal and laparoscopic radical hysterectomy for cervical cancer in China, 2004–2016: a retrospective cohort study

Liang

Liu

et al. 2023

BMC Women's Health

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“…Hospital surgical volume of trachelectomy was a predictor of fewer perioperative complications and shortterm hospitalization. These procedures should be performed in the top centres [13]. Radical trachelectomy, in comparison to radical hysterectomy, performed in early-stage cervical cancer allows for fewer intraoperative and postoperative complications, less blood loss, and shorter hospitalization [14].…”

Section: Introductionmentioning

confidence: 99%

Robotic radical abdominal trachelectomy in early-stage cervical cancer: safe removal of the cervix with underpressure colpotomizer – review report based on case study

Bizoń¹,

Olszewski²,

Balawender³

et al. 2023

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Fertility preservation is a procedure of conservative surgery which may be performed in the early stage of cervical cancer as radical trachelectomy. The aim of the study is to describe the first robotic radical trachelectomy in Poland with safe cervical sample extraction using an underpressure manipulator. Robotic abdominal trachelectomy was performed in a 42-year-old nullipara with squamous cell cervical carcinoma G2 using an underpressure manipulator. No complications were observed. Mobilization of the patient began the day after the surgical procedure. The long-term obstetric and oncologic outcome of this technique would be expected to match the outcome of the other radical trachelectomy techniques in the published literature. Using of an underpressure manipulator decreases the risk of cervical tumour spread during the surgery. To our knowledge, this is the first description of safe radical trachelectomy specimen extraction using an underpressure colpotomizer. StreszczenieLeczenie oszczędzające płodność może być rozważane w przypadku wczesnych stopni zaawansowania raka szyjki macicy jako radykalna trachelektomia. Celem pracy był opis pierwszej przeprowadzonej w Polsce radykalnej trachelektomii w asyście robota z użyciem podciśnieniowego manipulatora. Radykalną robotyczną trachelektomię z użyciem podciśnieniowego manipulatora przeprowadzono u 42-letniej nieródki z rozpoznaniem płaskonabłonkowego raka szyjki macicy G2. Okres około-i pooperacyjny przebiegał bez powikłań. Pacjentka została uruchomiona następnego dnia po operacji. W piśmiennictwie opisywane są długoterminowe korzystne wyniki położnicze i onkologicznej u pacjentek po przebytej radykalnej trachelektomii. Użycie podciśnieniowego manipulatora zmniejsza ryzyko rozprzestrzeniania się komórek guza w trakcie operacji. To pierwszy taki opis radykalnej robotycznej trachelektomii z użyciem podciśnieniowego manipulatora.

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“…However, the application of the HPV vaccine in non-developed countries has not been popularized [ 3 , 4 ]. Surgical resections after the diagnosis of the disease also cause permanent damage to the human body [ 5 , 6 ]. The progression of the HPV infection to cervical cancer takes decades.…”

Section: Introductionmentioning

confidence: 99%

Inhibitory Effect of Salvia miltiorrhiza Extract and Its Active Components on Cervical Intraepithelial Neoplastic Cells

Leng

Kan

et al. 2022

Molecules

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The effective treatment of cervical intraepithelial neoplasia (CIN) can prevent cervical cancer. Salvia miltiorrhiza is a medicinal and health-promoting plant. To identify a potential treatment for CIN, the effect of S. miltiorrhiza extract and its active components on immortalized cervical epithelial cells was studied in vitro. The H8 cell was used as a CIN model. We found that S. miltiorrhiza extract effectively inhibited H8 cells through the CCK8 method. An HPLC–MS analysis revealed that S. miltiorrhiza extract contained salvianolic acid H, salvianolic acid A, salvianolic acid B, monomethyl lithospermate, 9′′′-methyl lithospermate B, and 9′′′-methyl lithospermate B/isomer. Salvianolic acid A had the best inhibitory effect on H8 cells with an IC50 value of 5.74 ± 0.63 μM. We also found that the combination of salvianolic acid A and oxysophoridine had a synergistic inhibitory effect on H8 cells at molar ratios of 4:1, 2:1, 1:1, 1:2, and 1:4, with salvianolic acid A/oxysophoridine = 1:2 having the best synergistic effect. Using Hoechst33342, flow cytometry, and Western blotting analysis, we found that the combination of salvianolic acid A and oxysophoridine can induce programmed apoptosis of H8 cells and block the cell cycle in the G2/M phase, which was correlated with decreased cyclinB1 and CDK1 protein levels. In conclusion, S. miltiorrhiza extract can inhibit the growth of H8 cells, and the combination of salvianolic acid A (its active component) and oxysophoridine has a synergistic inhibitory effect on H8 cells and may be a potential treatment for cervical intraepithelial neoplasia.

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Association between hospital surgical volume and perioperative outcomes of fertility-sparing trachelectomy for cervical cancer: A national study in the United States

Cited by 16 publications

References 36 publications

Effect of annualized surgeon volume on major surgical complications for abdominal and laparoscopic radical hysterectomy for cervical cancer in China, 2004–2016: a retrospective cohort study

Effect of annualized surgeon volume on major surgical complications for abdominal and laparoscopic radical hysterectomy for cervical cancer in China, 2004–2016: a retrospective cohort study

Robotic radical abdominal trachelectomy in early-stage cervical cancer: safe removal of the cervix with underpressure colpotomizer – review report based on case study

Inhibitory Effect of Salvia miltiorrhiza Extract and Its Active Components on Cervical Intraepithelial Neoplastic Cells

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