%0 Journal Article
%A Fernandez-Gonzalez, Sergi
%A Ponce, Jordi
%A Martínez-Maestre, María Ángeles
%A Barahona, Marc
%A Gómez-Hidalgo, Natalia R
%A Díaz-Feijoo, Berta
%A Casajuana, Andrea
%A Gracia, Myriam
%A Frias-Gomez, Jon
%A Benavente, Yolanda
%A Costas, Laura
%A Martí, Lola
%A Melero, Lidia
%A Silvan, Jose Manuel
%A Beiro, Eva
%A Lobo, Ignacio
%A De la Rosa, Jesús
%A Coronado, Pluvio J
%A Gil-Moreno, Antonio
%T The Impact of Surgical Practice on Oncological Outcomes in Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer, Spanish National Registry.
%D 2022
%@ 2072-6694
%U http://hdl.handle.net/10668/20871
%X This study aimed to assess whether surgical practice had a significant impact on oncological outcomes among women who underwent robot-assisted radical hysterectomy for early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009). The secondary objective was to audit the pre-surgical quality indicators (QI) proposed by the European Society of Gynaecological Oncology (ESGO). The top 5 of 10 centers in Spain and Portugal were included in the analysis. The hospitals were divided into group A (n = 118) and group B (n = 97), with recurrence rates of 10%, respectively. After balancing both groups using the propensity score, the ORs for all events were higher and statistically significant for group B (recurrences OR = 1.23, 95% CI = 1.13-1.15, p-value = 0.001; death OR = 1.10, 95% CI = 1.02-1.18, p-value = 0.012; disease-specific mortality ORr = 1.11, 95% CI = 1.04-1.19, p-value = 0.002). A higher surgical volume, higher participation in clinical trials, higher rate of MRI use for diagnosis, greater use of sentinel lymph node biopsies, and a favorable learning curve with low rates of early recurrences were observed among the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes not only after robot-assisted surgery, but also after laparoscopies and open surgeries in the treatment of cervical cancer.
%K disease-free survival
%K early-stage cervical cancer
%K oncological outcome
%K radical hysterectomy
%K recurrence
%K robotic surgery
%K surgery
%K surgical practice
%~