Evidence map›Paper›PMID 36701621›Full record

ArticleObstetrics and gynecology2023

Association of Hospital Surgical Volume With Survival in Early-Stage Cervical Cancer Treated With Radical Hysterectomy.

Nicolò Bizzarri, Lukáš Dostálek, Luc R C W van Lonkhuijzen, Diana Giannarelli, Aldo Lopez, Henrik Falconer, Denis Querleu, Ali Ayhan, Sarah H Kim, David Isla Ortiz and 22 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Obstetrics and gynecology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors at 1 institution in 1 country.

Nicolò BizzarriUOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, and the Biostatistics Unit, Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, and the University of Milano-Bicocca, Department of Obstetrics and Gynecology, Gynaecologic Oncology Surgical Unit, ASST-Monza, San Gerardo Hospital, Monza, Italy; the Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital (Central and Eastern European Gynecologic Oncology Group, CEEGOG), and the Department of Gynaecology and Obstetrics, University Hospital Pilsen, Charles University, Prague, the Department of Obstetrics and Gynecology, Faculty of Medicine, University Hospital and University of Ostrava, Ostrava, and the University Hospital Brno, Medical Faculty of Masaryk University, Brno, Czech Republic; the Center for Gynaecologic Oncology Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands; the Department of Gynecological Surgery, National Institute of Neoplastic Diseases, Lima, Peru; the Department of Pelvic Cancer, Karolinska University Hospital and Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; the Baskent University School of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, and the Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health and Research Hospital, University of Health Sciences, Ankara, Turkey; Memorial Sloan Kettering Cancer Center, New York, New York; the Gynecology Oncology Center, National Institute of Cancerology Mexico, Mexico City, Mexico; the Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia; the Wolfson Institute of Preventive Medicine, Barts Cancer Centre, Queen Mary University of London, & Barts Health NHS Trust, London, United Kingdom; the Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; the Department of Gynecologic Oncology, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina; Gynecology, Medical University of Graz, Graz, Austria; the Gynecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain; and the Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil.
Lukáš Dostálek
Luc R C W van Lonkhuijzen
Diana Giannarelli
Aldo Lopez
Henrik Falconer
Denis Querleu
Ali Ayhan
Sarah H Kim
David Isla Ortiz
Jaroslav Klat
Fabio Landoni
Juliana Rodriguez
Ranjit Manchanda
Jan Kosťun
Pedro T Ramirez
Mehmet M Meydanli
Diego Odetto
Rene Laky
Ignacio Zapardiel
Vit Weinberger
Ricardo Dos Reis
Luigi Pedone Anchora
Karina Amaro
Sahar Salehi
Huseyin Akilli
Nadeem R Abu-Rustum
Rosa A Salcedo-Hernández
Veronika Javůrková
Constantijne H Mom
Giovanni Scambia
David Cibula
University of Milano-Bicocca · IT

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

objectiveTo evaluate the association of number of radical hysterectomies performed per year in each center with disease-free survival and overall survival.

methodsWe conducted an international, multicenter, retrospective study of patients previously included in the Surveillance in Cervical Cancer collaborative studies. Individuals with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB1-IIA1 cervical cancer who underwent radical hysterectomy and had negative lymph nodes at final histology were included. Patients were treated at referral centers for gynecologic oncology according to updated national and international guidelines. Optimal cutoffs for surgical volume were identified using an unadjusted Cox proportional hazard model, with disease-free survival as the outcome and defined as the value that minimizes the P-value of the split in groups in terms of disease-free survival. Propensity score matching was used to create statistically similar cohorts at baseline.

resultsA total of 2,157 patients were initially included. The two most significant cutoffs for surgical volume were identified at seven and 17 surgical procedures, dividing the entire cohort into low-volume, middle-volume, and high-volume centers. After propensity score matching, 1,238 patients were analyzed-619 (50.0%) in the high-volume group, 523 (42.2%) in the middle-volume group, and 96 (7.8%) in the low-volume group. Patients who underwent surgery in higher-volume institutions had progressively better 5-year disease-free survival than those who underwent surgery in lower-volume centers (92.3% vs 88.9% vs 83.8%, P=.029). No difference was noted in 5-year overall survival (95.9% vs 97.2% vs 95.2%, P=.70). Cox multivariable regression analysis showed that FIGO stage greater than IB1, presence of lymphovascular space invasion, grade greater than 1, tumor diameter greater than 20 mm, minimally invasive surgical approach, nonsquamous cell carcinoma histology, and lower-volume centers represented independent risk factors for recurrence.

conclusionSurgical volume of centers represented an independent prognostic factor affecting disease-free survival. Increasing number of radical hysterectomies performed in each center every year was associated with improved disease-free survival.

Indexed as

Uterine Cervical NeoplasmsDisease-Free SurvivalFemaleHospitalsHumansHysterectomyNeoplasm StagingRetrospective Studies

Identifiers

PMID36701621
PMCPMC10445691
OpenAlexW4311897991

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.