Publicaciones científicas

Radical hysterectomy in early cervical cancer in Europe: characteristics, outcomes and evaluation of ESGO quality indicators

28-jul-2021 | Revista: International Journal of Gynecological Cancer

Felix Boria  1 , Luis Chiva  2 , Vanna Zanagnolo  3 , Denis Querleu  4 , Nerea Martin-Calvo  5 , Mihai Emil Căpîlna  6 , Anna Fagotti  7 , Ali Kucukmetin  8 , Constantijne Mom  9 , Galina Chakalova  10 , Aliyev Shamistan  11 , Mario Malzoni  12 , Fabrice Narducci  13 , Octavio Arencibia  14 , Francesco Raspagliesi  15 , Tayfun Toptas  16 , David Cibula  17 , Dilyara Kaidarova  18 , Mehmet Mutlu Meydanli  19 , Mariana Tavares  20 , Dmytro Golub  21 , Anna Myriam Perrone  22 , Robert Poka  23 , Dimitrios Tsolakidis  24 , Goran Vujić  25 , Marcin A Jedryka  26 , Petra L M Zusterzeel  27 , Jogchum Jan Beltman  28 , Frederic Goffin  29 , Dimitrios Haidopoulos  30 , Herman Haller  31 , Robert Jach  32 , Iryna Yezhova  33 , Igor Berlev  34 , Margarida Bernardino  35 , Rasiah Bharathan  36 , Maximilian Lanner  37 , Minna M Maenpaa  38 , Vladyslav Sukhin  39   40 , Jean-Guillaume Feron  41 , Robert Fruscio  42   43 , Kersti Kukk  44 , Jordi Ponce  45 , María Alonso-Espías  46 , Jose Angel Minguez  47 , Daniel Vázquez-Vicente  48 , Nabil Manzour  49 , Matias Jurado  47 , Teresa Castellanos  48 , Enrique Chacon  50 , Juan Luis Alcazar  51


Introduction: Comprehensive updated information on cervical cancer surgical treatment in Europe is scarce.

Objective: To evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database.

Methods: The SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified.

Results: The mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0-84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation.

Conclusions: In this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.

CITA DEL ARTÍCULO  Int J Gynecol Cancer. 2021 Jul 28;ijgc-2021-002587. doi: 10.1136/ijgc-2021-002587

SOLICITE