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688 ESGO quality indicators (QI) in the surgical management of cervical cancer. Canary islands maternal and child university hospital
  1. O Arencibia Sanchez,
  2. AF Rave Ramirez,
  3. D González García-Cano,
  4. M Laseca Modrego and
  5. A Martín Martínez
  1. Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria , Gynecologic Oncology, las palmas de gran canaria, Spain


Introduction/Background*The objective is to know our degree of compliance with the ESGO 2019 quality indicators in surgical management of cervical cancer

Methodology Retrospective study of patients with cervical cancer who underwent laparoscopic radical hysterectomy in the period between 2008-2018.Multiple variables were analyzed related with histopathological study,surgical complications,adyuvant treatments,follow-up and current status of the patients.

Result(s)*109 radical hysterectomies were performed for cervical cancer during the study period.Average age is 46.5 years (range 25-76 years).Most of the patients (n = 101) had stage IB1.The mean tumor size is 1.8 cm (0.4-5 cm).In the first 30 days after surgery,3 fistulas were detected.In 99.1% the margins were free of disease,only one patient presented margin involvement.Two patients had a tumor stage greater than IB1 (1 IB2 and 1 IIA2).The mean number of lymph nodes extracted was 19.8, of those being affected 11.9% (n = 12). 18.3% (n = 20) received adjuvant treatment with radiotherapy + concomitant chemotherapy,of these 13 were for positive lymph nodes.Therefore, the rate of patients who received adjuvant treatment with N0 was 8.3%.We have only had one recurrence in less than two years of follow up (1/93).

Conclusion*HUMIC is a reference in gynecological oncology for the province of Las Palmas with trained personnel with exclusive dedication (QI2) and participating in multicenter studies (QI 3).It has a multidisciplinary tumor board where all patients are presented according to recommendations of scientific societies (QI4-5)before and after surgery (QI6-7).We present a 2.7% urological fistula (QI8 and QI9 <3%) all of them during learning curve and a patient with BMI of 38. We reached a 99.1% rate of free margins of disease (QI10> 97%).In 2% we found a staging greater tan IB1 (QI11 <10%).Pelvic lymphadenectomy or SLN (Sentix) was performed at 100% the patients (QI13> 98%).8.3% received adjuvant treatment with N0 (QI15 <15%). If there is indication, fertility sparing treatment is offered and currently it is performed in our center (QI14 100%).We had a 2-year recurrence rate of 1% (QI12 <10%).

The only indicator we do not reach is the number of cases (minimum QI1 of 15),since our mean is 10 radical hysterectomies per year.Nevertheless,last year we performed 15 surgeries,wich,given our geographical location,we think it allows us to continue as a Reference Center

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