The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer

Overview

Journal Front Surg

Specialty General Surgery

Date 2021 Sep 24

PMID 34557515

Citations 1

Authors

Pengfei Li

Jiaqi Liu

Li Wang

Shang Kang

Ying Yang

Jianxin Guo

Jilong Yao

Anwei Lu

Zhonghai Wang

Bin Lin

Zhiqiang Li

Xiaonong Bin

Jinghe Lang

Ping Liu

Chunlin Chen

Affiliations

Soon will be listed here.

Abstract

To examine the association between surgical volume and surgical and oncological outcomes of women with stage IB1 cervical cancer who underwent laparoscopic radical hysterectomy (LRH). We retrospectively analyzed the oncological outcomes of 1,137 patients with stage IB1 cervical cancer receiving LRH from 2004 to 2016. The surgical volume for each surgeon was defined as low [fewer than 50 surgeries, = 392(34.5%)], mid [51-100 surgeries, = 315(27.7%)], and high [100 surgeries or more, = 430(37.8%)]. Surgical volume-specific survival was examined with Kaplan-Meier analysis, multivariable analysis, and propensity score matching. The operative times of the high-volume group (227.35 ± 7.796 min) were significantly shorter than that of the low- (272.77 ± 4.887 min, < 0.001) and mid-volume (255.86 ± 4.981 min, < 0.001) groups. Blood loss in the high-volume group (169.42 ± 8.714 ml) was significantly less than that in the low-volume group (219.24 ± 11.299 ml, = 0.003). The 5-year disease-free survival (DFS) and overall survival (OS) in the low-volume, mid-volume, and high-volume groups were similar (DFS: 91.9, 86.7, and 89.2%, = 0.102; OS: 96.4, 93.5, and 94.2%, = 0.192). Multivariable analysis revealed surgical volume was not an independent risk factor for OS or DFS. The rate of intraoperative and postoperative complications was similar among the three groups ( = 0.210). Surgical volume of LRH may not be a prognostic factor for patients with stage IB1 cervical cancer. Surgery at high-volume surgeon is associated with decreased operative time and blood loss.

Citing Articles

Trends in Surgical Morbidity and Survival Outcomes for Radical Hysterectomy in West China: An 11-Year Retrospective Cohort Study.

Jing H, Yang Y, Liu Y, Zou P, Li Z Front Oncol. 2022; 12:836481.

PMID: 35223516 PMC: 8866646. DOI: 10.3389/fonc.2022.836481.

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