488 Validation of structural and process ESGO quality indicators for surgical treatment of cervical cancer in a large European cohort

Autor: D Vazquez, F Boria, L Sánchez Lorenzo, T Castellano, J. L. Alcazar, E Chacon, N Manzour, Antonio González-Martín, Luis Chiva, N Martin, Teresa Iscar, Jaime Espinós, José Ángel Mínguez, Mauricio Cambeiro
Rok vydání: 2021
Předmět:
Zdroj: Cervical cancer.
Popis: Introduction/Background* Implementation of quality surgical care programs as a component of comprehensive multi-disciplinary management has been shown to improve outcomes in patients with colorectal cancer and other types of malignancies.1,2 In that scenario, the ESGO quality indicators for surgical treatment of cervical cancer were published. 3 The aim of this study was to validate quality indicators for surgical treatment of cervical cancer in a large European retrospective cohort and to analyze if its accomplishment may impact the disease-free survival (DFS) in patients with cervical cancer. Methodology The succor database was fulfilled in 2019 for the succor study 4, comprising a total of of 1272 patients who underwent radical hysterectomy for IB1 cervical cancer in Europe between 2013 and 2014. In March 2021 a survey was conducted among all the Succor participating centers. The questionnaire included questions regarding the accomplishment of the ESGO process and structural quality indicators, comprising a total of 9 items with a maximum punctuation of 10. Potential factors that may influence on the relapse risk in this cohort were previously analyzed. 5l A regression cox analysis including all these factors and quality indicators accomplishment was conducted. Good accomplishment of QI was defined as accomplishment of 8 or more of them. Result(s)* A total of 82 out of the 126 participating institutions answered the survey. The final cohort was composed of 877 patients. Percentages of accomplishment of quality indicators are showed in table 1. Two groups were defined according to the number of quality indicators accomplished (Group 1: 7 or less vs group 2: 8 or more). The rate of DFS at 4.5 year for patients who underwent surgery in centers that accomplished 7 or less quality indicators was 82.1% (78.8-85.6) and 89.9% (88.7-91.1%) in the other group. Low accomplishment of QI was associated with a lower rate of disease-free survival than High accomplishment of QI (HR, 1.61; 95% CI, 1.01 to 2.57; P=0.047). A difference that remained after adjustment for previous conization, tumour size >2cm, and minimally invasive approach. Conclusion* Good accomplishment of structural and process QI was associated with a better DFS in this European cohort.
Databáze: OpenAIRE