Fernandez-Gonzalez, SergiPonce, JordiMartínez-Maestre, María ÁngelesBarahona, MarcGómez-Hidalgo, Natalia RDíaz-Feijoo, BertaCasajuana, AndreaGracia, MyriamFrias-Gomez, JonBenavente, YolandaCostas, LauraMartí, LolaMelero, LidiaSilvan, Jose ManuelBeiro, EvaLobo, IgnacioDe la Rosa, JesúsCoronado, Pluvio JGil-Moreno, Antonio2023-05-032023-05-032022-01-292072-6694http://hdl.handle.net/10668/20871This 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.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/disease-free survivalearly-stage cervical canceroncological outcomeradical hysterectomyrecurrencerobotic surgerysurgerysurgical practiceresearch article35158966open access10.3390/cancers14030698PMC8833333https://www.mdpi.com/2072-6694/14/3/698/pdf?version=1643448483https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833333/pdf