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

J 2023

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

BIZZARRI, Nicolò, Lukáš DOSTÁLEK, Luc R C W VAN LONKHUIJZEN, Diana GIANNARELLI, Aldo LOPEZ et. al.

Basic information

Original name

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

Authors

BIZZARRI, Nicolò, Lukáš DOSTÁLEK (203 Czech Republic), Luc R C W VAN LONKHUIJZEN, Diana GIANNARELLI, Aldo LOPEZ, Henrik FALCONER, Denis QUERLEU, Ali AYHAN, Sarah H KIM, David Isla ORTIZ, Jaroslav KLAT (203 Czech Republic), Fabio LANDONI, Juliana RODRIGUEZ, Ranjit MANCHANDA, Jan KOSŤUN, Pedro T RAMIREZ, Mehmet M MEYDANLI, Diego ODETTO, Rene LAKY, Ignacio ZAPARDIEL, Vít WEINBERGER (203 Czech Republic, belonging to the institution), Ricardo Dos REIS, Luigi Pedone ANCHORA, Karina AMARO, Sahar SALEHI, Huseyin AKILLI, Nadeem R ABU-RUSTUM, Rosa A SALCEDO-HERNÁNDEZ, Veronika JAVŮRKOVÁ (203 Czech Republic), Constantijne H MOM, Giovanni SCAMBIA and David CIBULA (203 Czech Republic)

Edition

Obstetrics and gynecology, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2023, 0029-7844

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30214 Obstetrics and gynaecology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 7.200 in 2022

RIV identification code

RIV/00216224:14110/23:00131348

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1097/AOG.0000000000005026

UT WoS

000926177900023

Keywords in English

Cervical Cancer; Radical Hysterectomy

Abstract

V originále

Objective: 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. Propensity score matching was used to create statistically similar cohorts at baseline. Results: A total of 2,157 patients were initially included. The two most significant cutoffs for surgical volume were identified at seven and 17 surgical procedures, dividing the entire cohort into low-volume, middle-volume, and high-volume centers. After propensity score matching, 1,238 patients were analyzed-619 (50.0%) in the high-volume group, 523 (42.2%) in the middle-volume group, and 96 (7.8%) in the low-volume group. Patients who underwent surgery in higher-volume institutions had progressively better 5-year disease-free survival than those who underwent surgery in lower-volume centers (92.3% vs 88.9% vs 83.8%, P=.029). No difference was noted in 5-year overall survival (95.9% vs 97.2% vs 95.2%, P=.70). Cox multivariable regression analysis showed that FIGO stage greater than IB1, presence of lymphovascular space invasion, grade greater than 1, tumor diameter greater than 20 mm, minimally invasive surgical approach, nonsquamous cell carcinoma histology, and lower-volume centers represented independent risk factors for recurrence. Conclusion: Surgical volume of centers represented an independent prognostic factor affecting disease-free survival. Increasing number of radical hysterectomies performed in each center every year was associated with improved disease-free survival.

Citovat

BIZZARRI, Nicolò, Lukáš DOSTÁLEK, Luc R C W VAN LONKHUIJZEN, Diana GIANNARELLI, Aldo LOPEZ, Henrik FALCONER, Denis QUERLEU, Ali AYHAN, Sarah H KIM, David Isla ORTIZ, Jaroslav KLAT, Fabio LANDONI, Juliana RODRIGUEZ, Ranjit MANCHANDA, Jan KOSŤUN, Pedro T RAMIREZ, Mehmet M MEYDANLI, Diego ODETTO, Rene LAKY, Ignacio ZAPARDIEL, Vít WEINBERGER, Ricardo Dos REIS, Luigi Pedone ANCHORA, Karina AMARO, Sahar SALEHI, Huseyin AKILLI, Nadeem R ABU-RUSTUM, Rosa A SALCEDO-HERNÁNDEZ, Veronika JAVŮRKOVÁ, Constantijne H MOM, Giovanni SCAMBIA and David CIBULA. Association of Hospital Surgical Volume With Survival in Early-Stage Cervical Cancer Treated With Radical Hysterectomy. Obstetrics and gynecology. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS, 2023, vol. 141, No 1, p. 207-214. ISSN 0029-7844. Available from: https://dx.doi.org/10.1097/AOG.0000000000005026.

@article{2300441,
   author = {Bizzarri, Nicolò and Dostálek, Lukáš and van Lonkhuijzen, Luc R C W and Giannarelli, Diana and Lopez, Aldo and Falconer, Henrik and Querleu, Denis and Ayhan, Ali and Kim, Sarah H and Ortiz, David Isla and Klat, Jaroslav and Landoni, Fabio and Rodriguez, Juliana and Manchanda, Ranjit and Kosťun, Jan and Ramirez, Pedro T and Meydanli, Mehmet M and Odetto, Diego and Laky, Rene and Zapardiel, Ignacio and Weinberger, Vít and Reis, Ricardo Dos and Anchora, Luigi Pedone and Amaro, Karina and Salehi, Sahar and Akilli, Huseyin and AbuandRustum, Nadeem R and SalcedoandHernández, Rosa A and Javůrková, Veronika and Mom, Constantijne H and Scambia, Giovanni and Cibula, David},
   article_location = {PHILADELPHIA},
   article_number = {1},
   doi = {http://dx.doi.org/10.1097/AOG.0000000000005026},
   keywords = {Cervical Cancer; Radical Hysterectomy},
   language = {eng},
   issn = {0029-7844},
   journal = {Obstetrics and gynecology},
   title = {Association of Hospital Surgical Volume With Survival in Early-Stage Cervical Cancer Treated With Radical Hysterectomy},
   url = {https://journals.lww.com/greenjournal/Fulltext/2023/01000/Association_of_Hospital_Surgical_Volume_With.23.aspx},
   volume = {141},
   year = {2023}
}

TY  - JOUR
ID  - 2300441
AU  - Bizzarri, Nicolò - Dostálek, Lukáš - van Lonkhuijzen, Luc R C W - Giannarelli, Diana - Lopez, Aldo - Falconer, Henrik - Querleu, Denis - Ayhan, Ali - Kim, Sarah H - Ortiz, David Isla - Klat, Jaroslav - Landoni, Fabio - Rodriguez, Juliana - Manchanda, Ranjit - Kosťun, Jan - Ramirez, Pedro T - Meydanli, Mehmet M - Odetto, Diego - Laky, Rene - Zapardiel, Ignacio - Weinberger, Vít - Reis, Ricardo Dos - Anchora, Luigi Pedone - Amaro, Karina - Salehi, Sahar - Akilli, Huseyin - Abu-Rustum, Nadeem R - Salcedo-Hernández, Rosa A - Javůrková, Veronika - Mom, Constantijne H - Scambia, Giovanni - Cibula, David
PY  - 2023
TI  - Association of Hospital Surgical Volume With Survival in Early-Stage Cervical Cancer Treated With Radical Hysterectomy
JF  - Obstetrics and gynecology
VL  - 141
IS  - 1
SP  - 207-214
EP  - 207-214
PB  - LIPPINCOTT WILLIAMS & WILKINS
SN  - 00297844
KW  - Cervical Cancer
KW  - Radical Hysterectomy
UR  - https://journals.lww.com/greenjournal/Fulltext/2023/01000/Association_of_Hospital_Surgical_Volume_With.23.aspx
N2  - Objective: 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. Propensity score matching was used to create statistically similar cohorts at baseline. Results: A total of 2,157 patients were initially included. The two most significant cutoffs for surgical volume were identified at seven and 17 surgical procedures, dividing the entire cohort into low-volume, middle-volume, and high-volume centers. After propensity score matching, 1,238 patients were analyzed-619 (50.0%) in the high-volume group, 523 (42.2%) in the middle-volume group, and 96 (7.8%) in the low-volume group. Patients who underwent surgery in higher-volume institutions had progressively better 5-year disease-free survival than those who underwent surgery in lower-volume centers (92.3% vs 88.9% vs 83.8%, P=.029). No difference was noted in 5-year overall survival (95.9% vs 97.2% vs 95.2%, P=.70). Cox multivariable regression analysis showed that FIGO stage greater than IB1, presence of lymphovascular space invasion, grade greater than 1, tumor diameter greater than 20 mm, minimally invasive surgical approach, nonsquamous cell carcinoma histology, and lower-volume centers represented independent risk factors for recurrence. Conclusion: Surgical volume of centers represented an independent prognostic factor affecting disease-free survival. Increasing number of radical hysterectomies performed in each center every year was associated with improved disease-free survival.
ER  -

BIZZARRI, Nicolò, Lukáš DOSTÁLEK, Luc R C W VAN LONKHUIJZEN, Diana GIANNARELLI, Aldo LOPEZ, Henrik FALCONER, Denis QUERLEU, Ali AYHAN, Sarah H KIM, David Isla ORTIZ, Jaroslav KLAT, Fabio LANDONI, Juliana RODRIGUEZ, Ranjit MANCHANDA, Jan KOSŤUN, Pedro T RAMIREZ, Mehmet M MEYDANLI, Diego ODETTO, Rene LAKY, Ignacio ZAPARDIEL, Vít WEINBERGER, Ricardo Dos REIS, Luigi Pedone ANCHORA, Karina AMARO, Sahar SALEHI, Huseyin AKILLI, Nadeem R ABU-RUSTUM, Rosa A SALCEDO-HERNÁNDEZ, Veronika JAVŮRKOVÁ, Constantijne H MOM, Giovanni SCAMBIA and David CIBULA. Association of Hospital Surgical Volume With Survival in Early-Stage Cervical Cancer Treated With Radical Hysterectomy. \textit{Obstetrics and gynecology}. PHILADELPHIA: LIPPINCOTT WILLIAMS \&{} WILKINS, 2023, vol.~141, No~1, p.~207-214. ISSN~0029-7844. Available from: https://dx.doi.org/10.1097/AOG.0000000000005026.

Detailed Information on Publication Record