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The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer
Purpose: 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). Methods: We retrospectively analyzed the oncological outcomes of 1,137 patients with stage IB1 cervical can...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8455083/ https://www.ncbi.nlm.nih.gov/pubmed/34557515 http://dx.doi.org/10.3389/fsurg.2021.692163 |
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author | Li, Pengfei Liu, Jiaqi Wang, Li Kang, Shang Yang, Ying Guo, Jianxin Yao, Jilong Lu, Anwei Wang, Zhonghai Lin, Bin Li, Zhiqiang Bin, Xiaonong Lang, Jinghe Liu, Ping Chen, Chunlin |
author_facet | Li, Pengfei Liu, Jiaqi Wang, Li Kang, Shang Yang, Ying Guo, Jianxin Yao, Jilong Lu, Anwei Wang, Zhonghai Lin, Bin Li, Zhiqiang Bin, Xiaonong Lang, Jinghe Liu, Ping Chen, Chunlin |
author_sort | Li, Pengfei |
collection | PubMed |
description | Purpose: 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). Methods: 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, n = 392(34.5%)], mid [51-100 surgeries, n = 315(27.7%)], and high [100 surgeries or more, n = 430(37.8%)]. Surgical volume-specific survival was examined with Kaplan–Meier analysis, multivariable analysis, and propensity score matching. Results: 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, p < 0.001) and mid-volume (255.86 ± 4.981 min, p < 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, p = 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%, p = 0.102; OS: 96.4, 93.5, and 94.2%, p = 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 (p = 0.210). Conclusions: 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. |
format | Online Article Text |
id | pubmed-8455083 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84550832021-09-22 The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer Li, Pengfei Liu, Jiaqi Wang, Li Kang, Shang Yang, Ying Guo, Jianxin Yao, Jilong Lu, Anwei Wang, Zhonghai Lin, Bin Li, Zhiqiang Bin, Xiaonong Lang, Jinghe Liu, Ping Chen, Chunlin Front Surg Surgery Purpose: 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). Methods: 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, n = 392(34.5%)], mid [51-100 surgeries, n = 315(27.7%)], and high [100 surgeries or more, n = 430(37.8%)]. Surgical volume-specific survival was examined with Kaplan–Meier analysis, multivariable analysis, and propensity score matching. Results: 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, p < 0.001) and mid-volume (255.86 ± 4.981 min, p < 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, p = 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%, p = 0.102; OS: 96.4, 93.5, and 94.2%, p = 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 (p = 0.210). Conclusions: 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. Frontiers Media S.A. 2021-09-07 /pmc/articles/PMC8455083/ /pubmed/34557515 http://dx.doi.org/10.3389/fsurg.2021.692163 Text en Copyright © 2021 Li, Liu, Wang, Kang, Yang, Guo, Yao, Lu, Wang, Lin, Li, Bin, Lang, Liu and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Li, Pengfei Liu, Jiaqi Wang, Li Kang, Shang Yang, Ying Guo, Jianxin Yao, Jilong Lu, Anwei Wang, Zhonghai Lin, Bin Li, Zhiqiang Bin, Xiaonong Lang, Jinghe Liu, Ping Chen, Chunlin The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer |
title | The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer |
title_full | The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer |
title_fullStr | The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer |
title_full_unstemmed | The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer |
title_short | The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer |
title_sort | effect of laparoscopic radical hysterectomy surgical volume on oncology outcomes in early-stage cervical cancer |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8455083/ https://www.ncbi.nlm.nih.gov/pubmed/34557515 http://dx.doi.org/10.3389/fsurg.2021.692163 |
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