TY - JOUR
T1 - Surgical skill and oncological outcome of laparoscopic radical hysterectomy
T2 - JGOG1081s-A1, an ancillary analysis of the Japanese Gynecologic Oncology Group Study JGOG1081
AU - Kobayashi, Eiji
AU - Nakatani, Eiji
AU - Tanaka, Tomohito
AU - Yosuke, Kawai
AU - Kanao, Hiroyuki
AU - Shiki, Yasuhiko
AU - Kotani, Yasushi
AU - Hoshiba, Tsutomu
AU - Minami, Rie
AU - Yoshida, Hiroshi
AU - Kyo, Satoru
AU - Yorimitsu, Masae
AU - Yamashita, Tsuyoshi
AU - Hasegawa, Tetsuya
AU - Matsuura, Toshiaki
AU - Kagami, Seiji
AU - Fujioka, Toru
AU - Hirohiko, Tanaka
AU - Nishio, Shin
AU - Takekuma, Munetaka
AU - Mikami, Mikio
AU - Enomoto, Takayuki
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/5
Y1 - 2022/5
N2 - Objectives: We investigated whether surgical skill and procedure were related to oncological outcomes in cervical cancer patients who underwent Laparoscopic Radical Hysterectomy (LRH). Methods: We previously assessed data of LRH from 251 patients with FIGO stage (2009) IA2, IB1and IIA1 cervical cancer collected for JGOG 1081s study. 1) The JGOG 1081s cohort study was re-examined to refine the surgical details and extend the follow-up period as chart review. 2) Unedited videos for recurrent cases and matched non-recurrent control cases were newly compared by experts for various surgical skills and surgical procedures using the modified Objective Structured Assessment of Technical Skills (OSATS) tool, without awareness of the recurrence status as video review. Results: After a median follow-up of 46 months, tumors had recurred in 31 of the 251 patients. The five-year Recurrence-Free Survival rate was 86.9% (81.8–90.6) and five-year Overall Survival rate was 93.7% (87.5–96.8). Multivariate analysis from chart reviews found that an experience with LRH of less than 20 cases per institution was an independent prognostic factor for recurrence (Hazard Ratio (HR) 2.49, 95%CI 1.12–5.53, p = 0.025). For the surgical video review, we compared 23 videos of recurrent cases with 23 background-matched non-recurrent controls. Lower modified OSATS scores from the video review were consistently trended to have a higher risk of recurrence. Conclusions: Our new study has found that LRH surgical experience and skill trended to have better oncological outcomes.
AB - Objectives: We investigated whether surgical skill and procedure were related to oncological outcomes in cervical cancer patients who underwent Laparoscopic Radical Hysterectomy (LRH). Methods: We previously assessed data of LRH from 251 patients with FIGO stage (2009) IA2, IB1and IIA1 cervical cancer collected for JGOG 1081s study. 1) The JGOG 1081s cohort study was re-examined to refine the surgical details and extend the follow-up period as chart review. 2) Unedited videos for recurrent cases and matched non-recurrent control cases were newly compared by experts for various surgical skills and surgical procedures using the modified Objective Structured Assessment of Technical Skills (OSATS) tool, without awareness of the recurrence status as video review. Results: After a median follow-up of 46 months, tumors had recurred in 31 of the 251 patients. The five-year Recurrence-Free Survival rate was 86.9% (81.8–90.6) and five-year Overall Survival rate was 93.7% (87.5–96.8). Multivariate analysis from chart reviews found that an experience with LRH of less than 20 cases per institution was an independent prognostic factor for recurrence (Hazard Ratio (HR) 2.49, 95%CI 1.12–5.53, p = 0.025). For the surgical video review, we compared 23 videos of recurrent cases with 23 background-matched non-recurrent controls. Lower modified OSATS scores from the video review were consistently trended to have a higher risk of recurrence. Conclusions: Our new study has found that LRH surgical experience and skill trended to have better oncological outcomes.
KW - Cervical Cancer
KW - Japan
KW - Laparoscopic radical hysterectomy
KW - Minimally invasive surgery
KW - OSATS
KW - Objective structured assessment of technical skills
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U2 - 10.1016/j.ygyno.2022.02.005
DO - 10.1016/j.ygyno.2022.02.005
M3 - Article
C2 - 35221133
AN - SCOPUS:85125487225
SN - 0090-8258
VL - 165
SP - 293
EP - 301
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 2
ER -