Association of Hospital Surgical Volume With Survival in Early-Stage Cervical Cancer Treated With Radical Hysterectomy

Abstract

To evaluate the association of number of radical hysterectomies performed per year in each center with disease-free survival and overall survival. METHODS: We conducted an international, multicenter, retrospective study of patients previously included in the Surveillance in Cervical Cancer collaborative studies. Individuals with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB1-IIA1 cervical cancer who underwent radical hysterectomy and had negative lymph nodes at final histology were included. Patients were treated at referral centers for gynecologic oncology according to updated national and international guidelines. Optimal cutoffs for surgical volume were identified using an unadjusted Cox proportional hazard model, with disease-free survival as the outcome and defined as the value that minimizes the P-value of the split in groups in terms of disease-free survival.

Improved bladder function in radical hysterectomy without worsening oncologic outcome: resection of the posterior layer of the vesicouterine ligament with the procedure limited to the vesical veins

“…The number of radical hysterectomies is decreasing in developed country, even in high-volume centers [ 32 ]. However, the hospital surgical volume significantly affects the oncologic outcomes of cervical cancer after a radical hysterectomy [ 33 34 ]. As the volumes decrease and experience with the procedure declines, we must reconsider the significance of radical hysterectomy and parametrial resection, and further investigation is warranted.…”

Survival associated with extent of radical hysterectomy in early-stage cervical cancer: a subanalysis of the Surveillance in Cervical CANcer (SCCAN) collaborative study

“…For this reason, referral to large-volume tertiary centers remains an important issue when dealing with patients with cervical cancer. 31 Moreover, this highlights the importance of adequate training on RH 32 to future generations of gynecologic oncology surgeons who will need to continue performing tailored radical surgery based on tumor characteristics.…”

Simple hysterectomy SHAPE-ing up to be the treatment of choice for early cervical cancer under 2 cm

“…A systematic review of the literature including 2,662 women demonstrated no significant association between mortality and simple vs. radical hysterectomy in patients with microscopic disease, and the recent SCCAN retrospective trial of 1,257 patients comparing type B, C1 and C2 radical hysterectomy techniques found no survival difference for tumors up to 2 cm with increased radicality of surgery [ 11 12 ].…”