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The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer
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  • Chunlin Chen,
  • Jiaqi Liu,
  • Pengfei Li,
  • Li Wang,
  • Shan Kang,
  • Ying Yang,
  • Jianxin Guo,
  • Jilong Yao,
  • Anwei Lu,
  • Zhonghai Wang,
  • Bin Ling,
  • Zhiqiang Li,
  • Xiaonong Bin,
  • Jinghe Lang,
  • Ping Liu
Chunlin Chen

Corresponding Author:[email protected]

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Jiaqi Liu
Southern Medical University Nanfang Hospital
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Pengfei Li
Southern Medical University Nanfang Hospital
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Li Wang
Henan Provincial Tumor Hospital
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Shan Kang
Fourth Hospital,Hebei Medical University
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Ying Yang
Xinqiao Hospital,Army Medical University
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Jianxin Guo
Daping hospital, Army Medical University
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Jilong Yao
Shenzhen maternal and Child Healthcare Hospital
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Zhonghai Wang
Shenzhen Nanshan District People's Hospital
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Bin Ling
China-Japan Friendship Hospital
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Zhiqiang Li
Southern Medical University Nanfang Hospital
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Xiaonong Bin
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Jinghe Lang
Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
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Abstract

Objective: To analyze the effect of surgical experience with laparoscopic radical hysterectomy (LRH) on oncological outcome in cervical cancer patients. Methods: We retrospectively compared the oncological outcomes of 1469 patients with stage IB1 cervical cancer receiving LRH from 2004 to 2016. The surgical volume for each surgeon was defined as low (fewer than 50 surgeries), mid (51-100 surgeries), and high (100 surgeries or more). Kaplan-Meier curves and the Cox proportional hazards model were used to estimate the effect of surgical experience on the oncological outcomes of patients. Results:A total of 1405 cases were included in this study. The average operative times of the low-volume (n = 427), mid-volume (n = 396) and high-volume (n=582) groups were 270, 260 and 227 minutes, respectively (P < 0·001), and mean blood loss was 218 ml, 197 ml and 179 ml, respectively (P = 0·004). The 5-year OS of the low-volume, mid-volume and high-volume groups was 96·1%, 93·1% and 92·5%, with 5-year DFS rates of 92·0%, 87·5% and 87·6%, respectively. There was no significant difference among the three groups. However, surgery volume was not an independent risk factor for shorter OS or DFS after controlling for case mix, nor was surgeons’ experience after 1:1 PSM (Propensity score matching) between each two of the three groups. Conclusion: The results showed that surgeons’ surgical volume did not affect the oncological outcome of LRH but that operative time and blood loss were significantly improved with a higher surgical volume.