Radical hysterectomy in early cervical cancer in Europe: Characteristics, outcomes and evaluation of ESGO quality indicators

Boria F. Chiva L. Zanagnolo V. Querleu D. Martin-Calvo N. CA Pîlna M.E. Fagotti A. Kucukmetin A. Mom C. Chakalova, G. Shamistan A. Malzoni M. Narducci F. Arencibia O. Raspagliesi F. Toptas T. Cibula D. Kaidarova D. Meydanli M.M. Tavares M. Golub D. Perrone A.M. Poka R. Tsolakidis D. Vujić G. Jedryka M.A. Zusterzeel P.L.M. Beltman J.J. Goffin F. Haidopoulos D. Haller H. Jach R. Yezhova I. Berlev I. Bernardino M. Bharathan R. Lanner M. Maenpaa M.M. Sukhin V. Feron J.-G. Fruscio R. Kukk K. Ponce J. Alonso-Espías M. Minguez J.A. Vázquez-Vicente D. Manzour N. Jurado M. Castellanos T. Chacon E. Alcazar J.L.
1 September 2021 BMJ Publishing Group

International Journal of Gynecological Cancer
2021 #31 Issue 9 1212 - 1219 pp.

Introduction Comprehensive updated information on cervical cancer surgical treatment in Europe is scarce. Objective To evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database. Methods The SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified. Results The mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m 2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0-84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation. Conclusions In this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.

cervical cancer , hysterectomy , postoperative complications , radiation , SLN and lympadenectomy

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Clinica Universidad de Navarra Departamento de Ginecologia y Obstetricia, Madrid, Spain
Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
Istituto Europeo di Oncologia, Anognnn, Milano, Italy
Department of Surgery, Institut Bergonie, Bordeaux, France
Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
Emergency County Hospital Targu-Mures, Targu Mures, Romania
Department of Woman Child, and Public Health, Fondazione Policlinico Universitario A Gemelli Irccs, Rome, Italy
Queen Elizabeth Hospital, Gateshead, Gateshead, United Kingdom
Amsterdam University Medical Centres, Noord-Holland, Amsterdam, Netherlands
University Oncologic Hospital, Sofia, Bulgaria
National Center of Oncology, Baku, Azerbaijan
Endoscopica Malzoni, Center for Advanced Endoscopic Gynecologic Surgery, Avellino, Italy
Department of Gynecology, Centre Oscar Lambret, Lille, France
University Maternal Hospital Canary Islands, Las Palma, Spain
Department of Surgery, Fondazione Irccs Istituto Nazionale Dei Tumori, Lombardia, Milano, Italy
Department of Gynecologic Oncology, Saglik Bilimleri University Antalya Research and Training Hospital, Antalya, Turkey
Department of Obstetrics and Gynecology, University of Prague, Prague, Czech Republic
Oncogynecology Kazahskij Naucno-Issledovatelskij, Institut Onkologii i Radiologii, Almaty, Kazakhstan
Department of Gynecologic Oncology, Zekai Tahir Burak Womens Health Education and Research Hospital, Ankara, Turkey
Instituto Português de Oncologia Do Porto Francisco Gentil, Porto, Portugal
Department of Surgery, Lisod - Israeli Oncological Hospital, Kyiv region, Ukraine
Azienda Ospedaliero-Universitaria di Bologna Policlinico SantOrsola-Malpighi, Bologna, Italy
Obstetrics and Gynecology, Unit of Gynecologic Oncology, Institute of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
General Hospital of Thessaloniki Papageorgiou, Central Macedonia, Thessaloniki, Greece
Clinical Hospital Center, Zagreb, Croatia
Department of Oncological Gynecology, Uniwersytet Medyczny im Piastów As LA...skich We Wrocławiu, Wroclaw Medical University, Wroclaw, Poland
Department of Gynecological Oncology, Nijmegen, Radboudumc, Netherlands
Department of Gynaecology, Lumc, Leiden, Netherlands
Department of Obstetrics and Gynecology, University of Liege, Liege, Belgium
Division of Gynecologic Oncology, 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
Clinical Hospital Center Rijeka, Rijeka, Croatia
Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland
Lviv Oncology Center, Lviv, Ukraine
North-Western State Medical University. N.N. Petrov Research, Institute of Oncology, Saint-Petersburg, Saint-Petersburg, Russian Federation
Department of Gynecology, Instituto Português de Oncologia de Lisboa, Lisboa, Portugal
University Hospitals of Leicester Nhs Trust, Leicester, United Kingdom
Kardinal Schwarzenbergsches Krankenhaus, Steiermark, Schwarzach, Austria
Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
Department of Oncology, Radiology and Radiation Medicine, V N Karazin Kharkiv National University, Harkiv, Ukraine
Department of Oncogynecology, Grigoriev Institute for Medical Radiology Nams of Ukraine, Harkiv, Ukraine
Institut Curie, Île-de-France, Paris, France
Department of Medicine and Surgery, University of Milan-Bicocca, Milano, Italy
Clinic of Obstetrics and Gynecology, Hospital San Gerardo, Monza, Italy
North Estonia Medical Centre, Tallinn, Estonia
Bellvitge University Hospital, LHospitalet de Llobregat, Catalunya, Spain
Department of Gynecologíc Oncology, Hospital Universitario la Paz, Madrid, Spain
Department of Gynecology, Clinica Universitaria de Navarra, Navarra, Pamplona, Spain
Department of Gynecology, Clinica Universitaria de Navarra, Madrid, Spain
Clinica Universidad de Navarra, Departamento de Ginecologia y Obstetricia, Navarra, Pamplona, Spain
Department of Gynecologic Oncology, Universidad de Navarra, Navarra, Pamplona, Spain
Department of Obstetrics and Gynecology, School of Medicine, University of Navarra, Pamplona, Spain

Clinica Universidad de Navarra Departamento de Ginecologia y Obstetricia
Department of Obstetrics and Gynecology
Istituto Europeo di Oncologia
Department of Surgery
Department of Preventive Medicine and Public Health
Emergency County Hospital Targu-Mures
Department of Woman Child
Queen Elizabeth Hospital
Amsterdam University Medical Centres
University Oncologic Hospital
National Center of Oncology
Endoscopica Malzoni
Department of Gynecology
University Maternal Hospital Canary Islands
Department of Surgery
Department of Gynecologic Oncology
Department of Obstetrics and Gynecology
Oncogynecology Kazahskij Naucno-Issledovatelskij
Department of Gynecologic Oncology
Instituto Português de Oncologia Do Porto Francisco Gentil
Department of Surgery
Azienda Ospedaliero-Universitaria di Bologna Policlinico SantOrsola-Malpighi
Obstetrics and Gynecology
General Hospital of Thessaloniki Papageorgiou
Clinical Hospital Center
Department of Oncological Gynecology
Department of Gynecological Oncology
Department of Gynaecology
Department of Obstetrics and Gynecology
Division of Gynecologic Oncology
Clinical Hospital Center Rijeka
Department of Gynecology and Oncology
Lviv Oncology Center
North-Western State Medical University. N.N. Petrov Research
Department of Gynecology
University Hospitals of Leicester Nhs Trust
Kardinal Schwarzenbergsches Krankenhaus
Department of Obstetrics and Gynecology
Department of Oncology
Department of Oncogynecology
Institut Curie
Department of Medicine and Surgery
Clinic of Obstetrics and Gynecology
North Estonia Medical Centre
Bellvitge University Hospital
Department of Gynecologíc Oncology
Department of Gynecology
Department of Gynecology
Clinica Universidad de Navarra
Department of Gynecologic Oncology
Department of Obstetrics and Gynecology

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