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Research article
Impact of Surgeons’ Experience on Oncologic Outcomes in Women Undergoing Laparoscopic Radical Hysterectomy for Cervical Cancer: A Comparison of the First 50 and last 50 Cases
Chunlin Chen
Southern Medical University Nanfang Hospital
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Objectives: To compare the oncological outcomes of the first 50 laparoscopic radical hysterectomy (LRH) surgeries with the last 50 LRH, performed by high volume surgeons, for cervical cancer patients.
Design: A nationwide multicentre retrospective cohort study
Setting: Clinical diagnosis and treatment of cervical cancer patients in mainland China (Four C) database.
Population: women with early cervical cancer undergone LRH.
Methods: We retrospectively analyzed the oncological outcomes of 1004 cervical cancer patients who underwent LRH performed by 19 surgeons. They were divided into two groups according to the sequence of operations, the first 50 and the last 50 patients with LRH. Kaplan-Meier survival analysis and log-rank test, Cox proportional risk regression model and propensity score matching were used.
Main Outcome Measures: 5-year overall survival (OS) and disease-free survival (DFS) rates.
Results: There were no significant differences in the 5-year OS and DFS between first 50 patients with LRH group (n=413) and last 50 patients with LRH group (n=591) (OS: p=0.388; DFS: p=0.226). The last 50 cases of LRH was not an independent risk factor for OS and DFS in early cervical cancer patients (p=0.830, p=0.300). After propensity score matching, similar outcomes were observed (n=364:364，OS:P = 0.764; DFS:P = 0.705).
Conclusions: The oncological outcomes of the first 50 LRH surgeries were similar to those of the last 50 surgeries in patients with early-stage cervical cancer. Increase in the surgeons’ experience did not improve significantly with oncological outcomes of patients with early stage cervical cancer after LRH.
Keywords
cervical cancer, laparoscopy, surgical experience, learning curve, oncological outcome
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This is a preprint. It has not completed peer review.
Research article
Impact of Surgeons’ Experience on Oncologic Outcomes in Women Undergoing Laparoscopic Radical Hysterectomy for Cervical Cancer: A Comparison of the First 50 and last 50 Cases
Chunlin Chen
Southern Medical University Nanfang Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 08 Jun, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objectives: To compare the oncological outcomes of the first 50 laparoscopic radical hysterectomy (LRH) surgeries with the last 50 LRH, performed by high volume surgeons, for cervical cancer patients.
Design: A nationwide multicentre retrospective cohort study
Setting: Clinical diagnosis and treatment of cervical cancer patients in mainland China (Four C) database.
Population: women with early cervical cancer undergone LRH.
Methods: We retrospectively analyzed the oncological outcomes of 1004 cervical cancer patients who underwent LRH performed by 19 surgeons. They were divided into two groups according to the sequence of operations, the first 50 and the last 50 patients with LRH. Kaplan-Meier survival analysis and log-rank test, Cox proportional risk regression model and propensity score matching were used.
Main Outcome Measures: 5-year overall survival (OS) and disease-free survival (DFS) rates.
Results: There were no significant differences in the 5-year OS and DFS between first 50 patients with LRH group (n=413) and last 50 patients with LRH group (n=591) (OS: p=0.388; DFS: p=0.226). The last 50 cases of LRH was not an independent risk factor for OS and DFS in early cervical cancer patients (p=0.830, p=0.300). After propensity score matching, similar outcomes were observed (n=364:364，OS:P = 0.764; DFS:P = 0.705).
Conclusions: The oncological outcomes of the first 50 LRH surgeries were similar to those of the last 50 surgeries in patients with early-stage cervical cancer. Increase in the surgeons’ experience did not improve significantly with oncological outcomes of patients with early stage cervical cancer after LRH.
Figure 1
Figure 2
Figure 3