Article Text
Abstract
Introduction/Background In 2021, the European Society of Gynaecological Oncology (ESGO) established 29 quality indicators (QI) aimed at guiding the surgical treatment of endometrial carcinoma. The number of cases treated per center is among these QI and is often utilized to assess whether a center can be considered a referral facility. This study aims to analyze the impact of undergoing surgery at a high-volume center for patients diagnosed with early-stage endometrial cancer.
Methodology The SENECA study was a retrospective, multicenter international observational analysis of data collected from 2139 women diagnosed with presurgical stage I-II endometrial cancer across 64 medical centers in 17 different countries. Between January 2021 and December 2022, patients underwent surgical treatment with SLN assessment. All quality indicators and surgical outcomes were integrated into a comprehensive database and meticulously documented as part of the study. The threshold for designating a center as a ‘high-volume center’ was set as ≥90 newly diagnosed cases of endometrial carcinoma treated per year. Surgical outcomes, QI and complete molecular profiling were compared between groups.
Results Out of the 2139 patients, 786 (36.7%) received surgical treatment at high-volume centers. Patients treated at high-volume centers exhibited lower rates of intraoperative and postoperative complications (1.1% vs. 4%; and 3.3% vs. 6.3; p<0.01), higher rates of bilateral sentinel lymph node detection (85.5% vs. 81.1%; p=0.01) and lower mean operative time (125 vs 155min; p<0.01). They also presented higher rates of complete molecular profiling (61.2% vs 54.4%; p<0.01) and greater adherence to ESGO QI (97% vs. 52.7%; p<0.01).
Conclusion Patients with early-stage endometrial cancer who underwent surgery at high-volume centers experienced improved surgical outcomes. This emphasizes the importance of centralizing patients with endometrial cancer.
Disclosures No disclosures.