Increased Institutional Surgical Experience in Robot-Assisted Radical Hysterectomy for Early Stage Cervical Cancer Reduces Recurrence Rate: Results from a Nationwide Study
| Autor: | Henrik Falconer, Petur Reynisson, Celine Lönnerfors, Emilia Alfonzo, Jan Persson, Emelie Wallin, Linnea Ekdahl, Pernilla Dahm-Kähler |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Referral cervical cancer lcsh:Medicine Lower risk Article recurrence rate 03 medical and health sciences 0302 clinical medicine robotic radical hysterectomy medicine Radical Hysterectomy Stage (cooking) Radio chemotherapy Cervical cancer 030219 obstetrics & reproductive medicine business.industry Obstetrics lcsh:R General Medicine medicine.disease learning curve 030220 oncology & carcinogenesis Cohort Registry data business |
| Zdroj: | Journal of Clinical Medicine Volume 9 Issue 11 Journal of Clinical Medicine, Vol 9, Iss 3715, p 3715 (2020) |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm9113715 |
| Popis: | The aim of this study was to evaluate the impact of institutional surgical experience on recurrence following robotic radical hysterectomy (RRH) for early stage cervical cancer. All women in Sweden who underwent an RRH for stage IA2-IB1 cervical cancer at tertiary referral centers from its implementation in December 2005 until June 2017 were identified using a Swedish nationwide register and local hospital registers. Registry data were controlled by a chart review of all women. Recurrence rates and patterns of recurrence were compared between early and late (&le 50 vs. > 50 procedures) institutional series. Six hundred and thirty-five women were included. Regression analysis identified a lower risk of recurrence with increased experience but without a clear cut off level. Among the 489 women who did not receive adjuvant radio chemotherapy (RC-T), the rate of recurrence was 3.6% in the experienced cohort (> 50 procedures) compared to 9.3% in the introductory cohort (p < 0.05). This was also seen in tumors < 2 cm regardless of RC-T (p < 0.05), whereas no difference in recurrence was seen when analyzing all women receiving RC-T. In conclusion, the rate of recurrence following RRH for early stage cervical cancer decreased with increased institutional surgical experience, in tumors < 2 cm and in women who did not receive adjuvant RC-T. |
| Databáze: | OpenAIRE |
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