RT Journal Article
SR Electronic
T1 245 The significance of surgical assessment in oncological outcomes after radical hysterectomy for early-stage cervical cancer. A multicenter study
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP A18
OP A19
DO 10.1136/ijgc-2021-ESGO.20
VO 31
IS Suppl 3
A1 S Fernandez-Gonzalez
A1 M Barahona
A1 A Gil-Moreno
A1 NR Gómez-Hidalgo
A1 B Diaz-Feijoo
A1 P Coronado
A1 V González
A1 A Casajuana
A1 JM Silvan
A1 L Melero
A1 MA Martinez
A1 J Hilario de la Rosa
A1 I Lobo
A1 E Beiro
A1 J Frias-Gomez
A1 Y Benavente
A1 C Ortega
A1 E Martinez
A1 L Marti
A1 J Ponce
YR 2021
UL http://ijgc.bmj.com/content/31/Suppl_3/A18.2.abstract
AB Introduction/Background*Patients with early-stage cervical cancer [CC] had worse prognosis when operated by minimal invasive surgery according to LACC trial. Different hypothesis were suggested such us the intrauterine manipulator, the CO2 or the lack of protective manoeuvre. However, the effect of surgical expertise among patients who underwent radical hysterectomy by the same approach has not been evaluated.Methodology All patients with early-stage CC (FIGO IA1-IIA1) undergoing robot-assisted radical hysterectomy in Spain and Portugal from 2009 to 2018 were included. Those centres with > 15 cases were selected. Centres with recurrence rate < 10% were gathered in group A an those ≥ 10% in group B. The primary objective was to compare the oncological outcomes between groups after balancing by Propensity Score [PS] analysis. The groups were balanced in age, BMI, histology, Size, tumoral grade, ILV and adjuvant treatment. Second primary objective was to audit the pre-surgical quality indicators [QI] proposed by ESGO.Result(s)*A total of 118 and 97 patients were well balanced (p-value 0.9483) between groups. 5 (4.3%) vs 19 (19.6%) recurrences occurred in group A vs group B, OR 1.23; (95% CI, 1,13-1,35) p-value of 0.001 after a median follow-up of 51 months. Overall mortality and disease-specific mortality were significant higher in group B, OR 1.07; (95% CI, 1.00-1.15) and 1.09; (95% CI, 1.02-1.16) respectively (figure 1). Five of eight Q.I were fulfilled by both groups. Lower rates of pre-operative assessment with M.R.I was observed in group B. 1 (20%) and 8 (42%) recurrences were observed during the first two years of robotic experience in group A and B (figure 2). Intraoperative and postoperative complications occurred in 0.8 vs 6.2% (p 0.028) and 5.1% vs 12.4% (p 0.055) in groups A and B respectively.Abstract 245 Figure 1 A) Disease-free survival rates between surgical; B) Odds of recurrence & mortality after balancingAbstract 245 Figure 2 (Group A and B) relation between time of recurrence and time of surgeryConclusion*We observed significant differences in recurrence rate, overall mortality and specific-disease mortality between hospitals. Pre-operative assessment with M.R.I and the effect of learning curve were factors related to higher rates of recurrence. The surgical assessment might be considered as an impact factor in oncological outcomes in patients who underwent radical hysterectomy by minimal invasive approach.