Impact of hospital care volume on clinical outcomes of laparoscopic radical hysterectomy for cervical cancer A systematic review and meta-analysis

Banghyun Lee, Kidong Kim, Youngmi Park, Myong Cheol Lim, Robert E. Bristow

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Background: In cervical cancer, the impact of hospital volume of laparoscopic radical hysterectomy (LRH) has not been investigated systematically as in ovarian cancer. The aim of this study was to investigate the impact of hospital care volume of LRH on treatment outcomes of patients with cervical cancer. Methods: The PubMed, Embase, and Cochrane Library databases were searched with the terms “cervical cancer,” “radical hysterectomy,” and “laparoscopy.” The selection criteria included studies presenting operative outcomes and/or perioperative complications of LRH from high-volume hospitals (HVHs) (≥15 cases/year) and low-volume hospitals (LVHs) (<15 cases/year). Fifty-nine studies including 4367 cases were selected. Linear regression analysis weighted by the average annual case number in each study was performed to evaluate differences between the groups. Results: In HVH, a higher number of lymph nodes (24.5 vs 21.1; P = .037) were retrieved by LRH in older women (48.4 vs 44.5 years; P = .010) with tendencies of shorter operation time (224.4 vs 256.4 minutes; P = .096) and less blood loss (253.1 vs 322.2 mL; P = .080). Compared with LVH, HVH had fewer patients with stage IA disease (13.8 vs 24.4%; P = .003) and more patients with stage IIA disease (15.3 vs 7.1%; P = .052) with comparable 5-year overall survival (93.1 vs 88.6%; P = .112). Conclusion: HVH is a prognostic factor for operative outcome and perioperative complications in patients with cervical cancer undergoing LRH. The exact effect of hospital volume on survival outcome needs to be evaluated.

Original languageEnglish
Article numbere13445
JournalMedicine (United States)
Volume97
Issue number49
DOIs
StatePublished - 1 Dec 2018

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Hysterectomy
High-Volume Hospitals
Uterine Cervical Neoplasms
Meta-Analysis
Low-Volume Hospitals
Cancer Care Facilities
Survival
PubMed
Ovarian Neoplasms
Laparoscopy
Patient Selection
Libraries
Linear Models
Lymph Nodes
Regression Analysis
Databases

Keywords

  • Cervical cancer
  • High-volume hospitals
  • Laparoscopic radical hysterectomy
  • Survival

Cite this

@article{32bf80b6672444ccafb211cc9ad284b4,
title = "Impact of hospital care volume on clinical outcomes of laparoscopic radical hysterectomy for cervical cancer A systematic review and meta-analysis",
abstract = "Background: In cervical cancer, the impact of hospital volume of laparoscopic radical hysterectomy (LRH) has not been investigated systematically as in ovarian cancer. The aim of this study was to investigate the impact of hospital care volume of LRH on treatment outcomes of patients with cervical cancer. Methods: The PubMed, Embase, and Cochrane Library databases were searched with the terms “cervical cancer,” “radical hysterectomy,” and “laparoscopy.” The selection criteria included studies presenting operative outcomes and/or perioperative complications of LRH from high-volume hospitals (HVHs) (≥15 cases/year) and low-volume hospitals (LVHs) (<15 cases/year). Fifty-nine studies including 4367 cases were selected. Linear regression analysis weighted by the average annual case number in each study was performed to evaluate differences between the groups. Results: In HVH, a higher number of lymph nodes (24.5 vs 21.1; P = .037) were retrieved by LRH in older women (48.4 vs 44.5 years; P = .010) with tendencies of shorter operation time (224.4 vs 256.4 minutes; P = .096) and less blood loss (253.1 vs 322.2 mL; P = .080). Compared with LVH, HVH had fewer patients with stage IA disease (13.8 vs 24.4{\%}; P = .003) and more patients with stage IIA disease (15.3 vs 7.1{\%}; P = .052) with comparable 5-year overall survival (93.1 vs 88.6{\%}; P = .112). Conclusion: HVH is a prognostic factor for operative outcome and perioperative complications in patients with cervical cancer undergoing LRH. The exact effect of hospital volume on survival outcome needs to be evaluated.",
keywords = "Cervical cancer, High-volume hospitals, Laparoscopic radical hysterectomy, Survival",
author = "Banghyun Lee and Kidong Kim and Youngmi Park and Lim, {Myong Cheol} and Bristow, {Robert E.}",
year = "2018",
month = "12",
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journal = "Medicine (United States)",
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Impact of hospital care volume on clinical outcomes of laparoscopic radical hysterectomy for cervical cancer A systematic review and meta-analysis. / Lee, Banghyun; Kim, Kidong; Park, Youngmi; Lim, Myong Cheol; Bristow, Robert E.

In: Medicine (United States), Vol. 97, No. 49, e13445, 01.12.2018.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Impact of hospital care volume on clinical outcomes of laparoscopic radical hysterectomy for cervical cancer A systematic review and meta-analysis

AU - Lee, Banghyun

AU - Kim, Kidong

AU - Park, Youngmi

AU - Lim, Myong Cheol

AU - Bristow, Robert E.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: In cervical cancer, the impact of hospital volume of laparoscopic radical hysterectomy (LRH) has not been investigated systematically as in ovarian cancer. The aim of this study was to investigate the impact of hospital care volume of LRH on treatment outcomes of patients with cervical cancer. Methods: The PubMed, Embase, and Cochrane Library databases were searched with the terms “cervical cancer,” “radical hysterectomy,” and “laparoscopy.” The selection criteria included studies presenting operative outcomes and/or perioperative complications of LRH from high-volume hospitals (HVHs) (≥15 cases/year) and low-volume hospitals (LVHs) (<15 cases/year). Fifty-nine studies including 4367 cases were selected. Linear regression analysis weighted by the average annual case number in each study was performed to evaluate differences between the groups. Results: In HVH, a higher number of lymph nodes (24.5 vs 21.1; P = .037) were retrieved by LRH in older women (48.4 vs 44.5 years; P = .010) with tendencies of shorter operation time (224.4 vs 256.4 minutes; P = .096) and less blood loss (253.1 vs 322.2 mL; P = .080). Compared with LVH, HVH had fewer patients with stage IA disease (13.8 vs 24.4%; P = .003) and more patients with stage IIA disease (15.3 vs 7.1%; P = .052) with comparable 5-year overall survival (93.1 vs 88.6%; P = .112). Conclusion: HVH is a prognostic factor for operative outcome and perioperative complications in patients with cervical cancer undergoing LRH. The exact effect of hospital volume on survival outcome needs to be evaluated.

AB - Background: In cervical cancer, the impact of hospital volume of laparoscopic radical hysterectomy (LRH) has not been investigated systematically as in ovarian cancer. The aim of this study was to investigate the impact of hospital care volume of LRH on treatment outcomes of patients with cervical cancer. Methods: The PubMed, Embase, and Cochrane Library databases were searched with the terms “cervical cancer,” “radical hysterectomy,” and “laparoscopy.” The selection criteria included studies presenting operative outcomes and/or perioperative complications of LRH from high-volume hospitals (HVHs) (≥15 cases/year) and low-volume hospitals (LVHs) (<15 cases/year). Fifty-nine studies including 4367 cases were selected. Linear regression analysis weighted by the average annual case number in each study was performed to evaluate differences between the groups. Results: In HVH, a higher number of lymph nodes (24.5 vs 21.1; P = .037) were retrieved by LRH in older women (48.4 vs 44.5 years; P = .010) with tendencies of shorter operation time (224.4 vs 256.4 minutes; P = .096) and less blood loss (253.1 vs 322.2 mL; P = .080). Compared with LVH, HVH had fewer patients with stage IA disease (13.8 vs 24.4%; P = .003) and more patients with stage IIA disease (15.3 vs 7.1%; P = .052) with comparable 5-year overall survival (93.1 vs 88.6%; P = .112). Conclusion: HVH is a prognostic factor for operative outcome and perioperative complications in patients with cervical cancer undergoing LRH. The exact effect of hospital volume on survival outcome needs to be evaluated.

KW - Cervical cancer

KW - High-volume hospitals

KW - Laparoscopic radical hysterectomy

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=85058763001&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000013445

DO - 10.1097/MD.0000000000013445

M3 - Review article

C2 - 30544427

AN - SCOPUS:85058763001

VL - 97

JO - Medicine (United States)

JF - Medicine (United States)

SN - 0025-7974

IS - 49

M1 - e13445

ER -