Increased Institutional Surgical Experience in Robot-Assisted Radical Hysterectomy for Early Stage Cervical Cancer Reduces Recurrence Rate: Results from a Nationwide Study
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 implement...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-11-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/9/11/3715 |
| _version_ | 1797547429200920576 |
|---|---|
| author | Linnea Ekdahl Emelie Wallin Emilia Alfonzo Petur Reynisson Celine Lönnerfors Pernilla Dahm-Kähler Henrik Falconer Jan Persson |
| author_facet | Linnea Ekdahl Emelie Wallin Emilia Alfonzo Petur Reynisson Celine Lönnerfors Pernilla Dahm-Kähler Henrik Falconer Jan Persson |
| author_sort | Linnea Ekdahl |
| collection | DOAJ |
| description | 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 (≤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 (<i>p</i> < 0.05). This was also seen in tumors < 2 cm regardless of RC-T (<i>p</i> < 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. |
| first_indexed | 2024-03-10T14:44:00Z |
| format | Article |
| id | doaj.art-92613e8ac1be4da3b37948b4c7fa4b39 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T14:44:00Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-92613e8ac1be4da3b37948b4c7fa4b392023-11-20T21:34:35ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-01911371510.3390/jcm9113715Increased Institutional Surgical Experience in Robot-Assisted Radical Hysterectomy for Early Stage Cervical Cancer Reduces Recurrence Rate: Results from a Nationwide StudyLinnea Ekdahl0Emelie Wallin1Emilia Alfonzo2Petur Reynisson3Celine Lönnerfors4Pernilla Dahm-Kähler5Henrik Falconer6Jan Persson7Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Skåne University Hospital, 22185 Lund, SwedenDepartment of Women’s and Children’s Health, Division of Neonatology, Obstetrics and Gynecology, Karolinska Institutet, 14186 Stockholm, SwedenDepartment of Obstetrics and Gynecology, Sahlgrenska University Hospital, 41345 Gothenburg, SwedenDepartment of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Skåne University Hospital, 22185 Lund, SwedenDepartment of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Skåne University Hospital, 22185 Lund, SwedenDepartment of Obstetrics and Gynecology, Sahlgrenska University Hospital, 41345 Gothenburg, SwedenDepartment of Women’s and Children’s Health, Division of Neonatology, Obstetrics and Gynecology, Karolinska Institutet, 14186 Stockholm, SwedenDepartment of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Skåne University Hospital, 22185 Lund, SwedenThe 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 (≤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 (<i>p</i> < 0.05). This was also seen in tumors < 2 cm regardless of RC-T (<i>p</i> < 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.https://www.mdpi.com/2077-0383/9/11/3715cervical cancerrobotic radical hysterectomyrecurrence ratelearning curve |
| spellingShingle | Linnea Ekdahl Emelie Wallin Emilia Alfonzo Petur Reynisson Celine Lönnerfors Pernilla Dahm-Kähler Henrik Falconer Jan Persson Increased Institutional Surgical Experience in Robot-Assisted Radical Hysterectomy for Early Stage Cervical Cancer Reduces Recurrence Rate: Results from a Nationwide Study Journal of Clinical Medicine cervical cancer robotic radical hysterectomy recurrence rate learning curve |
| title | Increased Institutional Surgical Experience in Robot-Assisted Radical Hysterectomy for Early Stage Cervical Cancer Reduces Recurrence Rate: Results from a Nationwide Study |
| title_full | Increased Institutional Surgical Experience in Robot-Assisted Radical Hysterectomy for Early Stage Cervical Cancer Reduces Recurrence Rate: Results from a Nationwide Study |
| title_fullStr | Increased Institutional Surgical Experience in Robot-Assisted Radical Hysterectomy for Early Stage Cervical Cancer Reduces Recurrence Rate: Results from a Nationwide Study |
| title_full_unstemmed | Increased Institutional Surgical Experience in Robot-Assisted Radical Hysterectomy for Early Stage Cervical Cancer Reduces Recurrence Rate: Results from a Nationwide Study |
| title_short | Increased Institutional Surgical Experience in Robot-Assisted Radical Hysterectomy for Early Stage Cervical Cancer Reduces Recurrence Rate: Results from a Nationwide Study |
| title_sort | increased institutional surgical experience in robot assisted radical hysterectomy for early stage cervical cancer reduces recurrence rate results from a nationwide study |
| topic | cervical cancer robotic radical hysterectomy recurrence rate learning curve |
| url | https://www.mdpi.com/2077-0383/9/11/3715 |
| work_keys_str_mv | AT linneaekdahl increasedinstitutionalsurgicalexperienceinrobotassistedradicalhysterectomyforearlystagecervicalcancerreducesrecurrencerateresultsfromanationwidestudy AT emeliewallin increasedinstitutionalsurgicalexperienceinrobotassistedradicalhysterectomyforearlystagecervicalcancerreducesrecurrencerateresultsfromanationwidestudy AT emiliaalfonzo increasedinstitutionalsurgicalexperienceinrobotassistedradicalhysterectomyforearlystagecervicalcancerreducesrecurrencerateresultsfromanationwidestudy AT peturreynisson increasedinstitutionalsurgicalexperienceinrobotassistedradicalhysterectomyforearlystagecervicalcancerreducesrecurrencerateresultsfromanationwidestudy AT celinelonnerfors increasedinstitutionalsurgicalexperienceinrobotassistedradicalhysterectomyforearlystagecervicalcancerreducesrecurrencerateresultsfromanationwidestudy AT pernilladahmkahler increasedinstitutionalsurgicalexperienceinrobotassistedradicalhysterectomyforearlystagecervicalcancerreducesrecurrencerateresultsfromanationwidestudy AT henrikfalconer increasedinstitutionalsurgicalexperienceinrobotassistedradicalhysterectomyforearlystagecervicalcancerreducesrecurrencerateresultsfromanationwidestudy AT janpersson increasedinstitutionalsurgicalexperienceinrobotassistedradicalhysterectomyforearlystagecervicalcancerreducesrecurrencerateresultsfromanationwidestudy |