TY - JOUR
T1 - SUCCOR quality
T2 - validation of ESGO quality indicators for surgical treatment of cervical cancer
AU - Boria, Felix
AU - Chiva, Luis
AU - Chacon, Enrique
AU - Zanagnolo, Vanna
AU - Fagotti, Anna
AU - Kucukmetin, Ali
AU - Mom, Constantijne
AU - Chakalova, Galina
AU - Shamistan, Aliyev
AU - Malzoni, Mario
AU - Narducci, Fabrice
AU - Arencibia, Octavio
AU - Raspagliesi, Francesco
AU - Toptas, Tayfun
AU - Cibula, David
AU - Kaidarova, Dilyara
AU - Meydanli, Mehmet Mutlu
AU - Tavares, Mariana
AU - Golub, Dmytro
AU - Perrone, Anna Myriam
AU - Poka, Robert
AU - Zusterzeel, Petra L. M.
AU - Aluloski, Igor
AU - Goffin, Frederic
AU - Haidopoulos, Dimitrios
AU - Haller, Herman
AU - Jach, Robert
AU - Yezhova, Iryna
AU - Bernardino, Margarida
AU - Bharathan, Rasiah
AU - Maenpaa, Minna M.
AU - Sukhin, Vladyslav
AU - Feron, Jean-Guillaume
AU - Fruscio, Robert
AU - Kukk, Kersti
AU - Ponce, Jordi
AU - Demirkiran, Fuat
AU - Vorgias, George
AU - Povolotskaya, Natalia
AU - Coronado Martín, Pluvio J.
AU - Marina, Tiermes
AU - Zapardiel, Ignacio
AU - Bizzarri, Nicolò
AU - Gorostidi, Mikel
AU - Gutierrez, Monica
AU - Manzour, Nabil
AU - Berasaluce, Arantxa
N1 - Publisher Copyright: © IGCS and ESGO 2022.
PY - 2022/10/3
Y1 - 2022/10/3
N2 - Objective To evaluate whether compliance with European Society of Gynaecological Oncology (ESGO) surgery quality indicators impacts disease-free survival in patients undergoing radical hysterectomy for cervical cancer. Methods In this retrospective cohort study, 15 ESGO quality indicators were assessed in the SUCCOR database (patients who underwent radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage 2009 IB1, FIGO 2018 IB1, and IB2 cervical cancer between January 2013 and December 2014), and the final score ranged between 0 and 16 points. Centers with more than 13 points were classified as high-quality indicator compliance centers. We constructed a weighted cohort using inverse probability weighting to adjust for the variables. We compared disease-free survival and overall survival using Cox proportional hazards regression analysis in the weighted cohort. Results A total of 838 patients were included in the study. The mean number of quality indicators compliance in this cohort was 13.6 (SD 1.45). A total of 479 (57.2%) patients were operated on at high compliance centers and 359 (42.8%) patients at low compliance centers. High compliance centers performed more open surgeries (58.4% vs 36.7%, p<0.01). Women who were operated on at centers with high compliance with quality indicators had a significantly lower risk of relapse (HR=0.39; 95% CI 0.25 to 0.61; p<0.001). The association was reduced, but remained significant, after further adjustment for conization, surgical approach, and use of manipulator surgery (HR=0.48; 95% CI 0.30 to 0.75; p=0.001) and adjustment for adjuvant therapy (HR=0.47; 95% CI 0.30 to 0.74; p=0.001). Risk of death from disease was significantly lower in women operated on at centers with high adherence to quality indicators (HR=0.43; 95% CI 0.19 to 0.97; p=0.041). However, the association was not significant after adjustment for conization, surgical approach, use of manipulator surgery, and adjuvant therapy. Conclusions Patients with early cervical cancer who underwent radical hysterectomy in centers with high compliance with ESGO quality indicators had a lower risk of recurrence and death.
AB - Objective To evaluate whether compliance with European Society of Gynaecological Oncology (ESGO) surgery quality indicators impacts disease-free survival in patients undergoing radical hysterectomy for cervical cancer. Methods In this retrospective cohort study, 15 ESGO quality indicators were assessed in the SUCCOR database (patients who underwent radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage 2009 IB1, FIGO 2018 IB1, and IB2 cervical cancer between January 2013 and December 2014), and the final score ranged between 0 and 16 points. Centers with more than 13 points were classified as high-quality indicator compliance centers. We constructed a weighted cohort using inverse probability weighting to adjust for the variables. We compared disease-free survival and overall survival using Cox proportional hazards regression analysis in the weighted cohort. Results A total of 838 patients were included in the study. The mean number of quality indicators compliance in this cohort was 13.6 (SD 1.45). A total of 479 (57.2%) patients were operated on at high compliance centers and 359 (42.8%) patients at low compliance centers. High compliance centers performed more open surgeries (58.4% vs 36.7%, p<0.01). Women who were operated on at centers with high compliance with quality indicators had a significantly lower risk of relapse (HR=0.39; 95% CI 0.25 to 0.61; p<0.001). The association was reduced, but remained significant, after further adjustment for conization, surgical approach, and use of manipulator surgery (HR=0.48; 95% CI 0.30 to 0.75; p=0.001) and adjustment for adjuvant therapy (HR=0.47; 95% CI 0.30 to 0.74; p=0.001). Risk of death from disease was significantly lower in women operated on at centers with high adherence to quality indicators (HR=0.43; 95% CI 0.19 to 0.97; p=0.041). However, the association was not significant after adjustment for conization, surgical approach, use of manipulator surgery, and adjuvant therapy. Conclusions Patients with early cervical cancer who underwent radical hysterectomy in centers with high compliance with ESGO quality indicators had a lower risk of recurrence and death.
UR - http://www.scopus.com/inward/record.url?scp=85141660997&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/ijgc-2022-003790
DO - https://doi.org/10.1136/ijgc-2022-003790
M3 - Article
C2 - 36583728
SN - 1048-891X
VL - 32
SP - 1236
EP - 1243
JO - International journal of gynecological cancer
JF - International journal of gynecological cancer
IS - 10
ER -