8 research outputs found
Subspecialty training in Europe:a report by the European Network of Young Gynaecological Oncologists
Backgroun
Gender-related differences in career development among gynecologic oncology surgeons in Europe. European Network of Young Gynecologic Oncologists' Survey based data
Gender-related differences in career development are well known issues in various professions. An international survey on gender-related differences was performed among young gynecologic oncology surgeons in Europe to identify potential gender inequalities in career development. A survey on demographics, clinical and academic working environment, family/parenting, career development, salary and leadership was sent to all members of the European Network of Young Gynecologic Oncologists (ENYGO), which is a network within the European Society of Gynecologic Oncology (ESGO). Gynecologic oncology surgeons and obstetricians/gynecologists who actively work in this field in Europe were included in the study. Responses were analyzed from 192 gynecologic oncology surgeons of whom 65.1% (125/192) were female (median age 37, IQR: 34 - 42) and 34.9% (67/192) were male (median age 38, IQR: 36 - 41). Male reported to perform a median of 15 and female a median of 10 operations per month (p =. 007). Among female, 24.8% had a leadership position vs. 44.8% among male, crude OR = 2.46, 95% CI 1.31-4.62, p<.01. When stratifying for age under 41 and having children, 36.7% of male and 5.6% of female had a leadership position, adjusted OR 10.8, 95% CI 3.28-35.64, p <.001. A significantly higher proportion of female compared to male believed they earned less than their gender counterparts at the same clinical position and with same qualifications (30.4% vs. 2.5%, p<.001). There was not a statistically significant gender difference in the academic qualification PhD degree or professorship (p =.92 and p =.64, respectively). In the previous year, male published more peer-reviewed articles than female (median 3 vs. median 2; p =.017). This first comprehensive survey on gender-differences in gynecologic oncology in Europe revealed that there are gender gaps concerning several aspects during the critical time of career development in the young generation of gynecologic oncology surgeons. These gender gaps are particularly reflected by a lower rate of female leadership positions. ENYGO and ESGO are dedicated to work on solution to overcome the identified obstacles and to support closing gender gap
Radical hysterectomy in early cervical cancer in Europe : characteristics, outcomes and evaluation of ESGO quality indicators
Introduction Comprehensive updated information on cervical cancer surgical treatment in Europe is scarce. Objective To evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database. Methods The SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified. Results The mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m(2) (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0-84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation. Conclusions In this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.Cervix cance
Radical hysterectomy in early cervical cancer in Europe: characteristics, outcomes and evaluation of ESGO quality indicators
Introduction Comprehensive updated information on cervical cancer
surgical treatment in Europe is scarce. Objective To evaluate baseline
characteristics of women with early cervical cancer and to analyze the
outcomes of the ESGO quality indicators after radical hysterectomy in
the SUCCOR database. Methods The SUCCOR database consisted of 1272
patients who underwent radical hysterectomy for stage IB1 cervical
cancer (FIGO 2009) between January 2013 and December 2014. After
exclusion criteria, the final sample included 1156 patients. This study
first described the clinical, surgical, pathological, and follow-up
variables of this population and then analyzed the outcomes
(disease-free survival and overall survival) after radical hysterectomy.
Surgical-related ESGO quality indicators were assessed and the
accomplishment of the stated recommendations was verified. Results The
mean age of the patients was 47.1 years (SD 10.8), with a mean body mass
index of 25.4 kg/m(2) (SD 4.9). A total of 423 (36.6%) patients had a
previous cone biopsy. Tumor size (clinical examination) <2 cm was
observed in 667 (57.7%) patients. The most frequent histology type was
squamous carcinoma (794 (68.7%) patients), and positive lymph nodes
were found in 143 (12.4%) patients. A total of 633 (54.8%) patients
were operated by open abdominal surgery. Intra-operative complications
occurred in 108 (9.3%) patients, and post-operative complications
during the first month occurred in 249 (21.5%) patients, with bladder
dysfunction as the most frequent event (119 (10.3%) patients).
Clavien-Dindo grade III or higher complication occurred in 56 (4.8%)
patients. A total of 510 (44.1%) patients received adjuvant therapy.
After a median follow-up of 58 months (range 0-84), the 5-year
disease-free survival was 88.3%, and the overall survival was 94.9%.
In our population, 10 of the 11 surgical-related quality indicators
currently recommended by ESGO were fully fulfilled 5 years before its
implementation. Conclusions In this European cohort, the rate of
adjuvant therapy after radical hysterectomy is higher than for most
similar patients reported in the literature. The majority of centers
were already following the European recommendations even 5 years prior
to the ESGO quality indicator implementations
SUCCOR cone study : conization before radical hysterectomy
peer reviewed[en] OBJECTIVE: To evaluate disease-free survival of cervical conization prior to radical hysterectomy in patients with stage IB1 cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) 2009).
METHODS: A multicenter retrospective observational cohort study was conducted including patients from the Surgery in Cervical Cancer Comparing Different Surgical Aproaches in Stage IB1 Cervical Cancer (SUCCOR) database with FIGO 2009 IB1 cervical carcinoma treated with radical hysterectomy between January 1, 2013, and December 31, 2014. We used propensity score matching to minimize the potential allocation biases arising from the retrospective design. Patients who underwent conization but were similar for other measured characteristics were matched 1:1 to patients from the non-cone group using a caliper width ≤0.2 standard deviations of the logit odds of the estimated propensity score.
RESULTS: We obtained a weighted cohort of 374 patients (187 patients with prior conization and 187 non-conization patients). We found a 65% reduction in the risk of relapse for patients who had cervical conization prior to radical hysterectomy (hazard ratio (HR) 0.35, 95% confidence interval (CI) 0.16 to 0.75, p=0.007) and a 75% reduction in the risk of death for the same sample (HR 0.25, 95% CI 0.07 to 0.90, p=0.033). In addition, patients who underwent minimally invasive surgery without prior conization had a 5.63 times higher chance of relapse compared with those who had an open approach and previous conization (HR 5.63, 95% CI 1.64 to 19.3, p=0.006). Patients who underwent minimally invasive surgery with prior conization and those who underwent open surgery without prior conization showed no differences in relapse rates compared with those who underwent open surgery with prior cone biopsy (reference) (HR 1.94, 95% CI 0.49 to 7.76, p=0.349 and HR 2.94, 95% CI 0.80 to 10.86, p=0.106 respectively).
CONCLUSIONS: In this retrospective study, patients undergoing cervical conization before radical hysterectomy had a significantly lower risk of relapse and death
SUCCOR cone study: conization before radical hysterectomy
Objective To evaluate disease-free survival of cervical conization prior
to radical hysterectomy in patients with stage IB1 cervical cancer
(International Federation of Gynecology and Obstetrics (FIGO) 2009).
Methods A multicenter retrospective observational cohort study was
conducted including patients from the Surgery in Cervical Cancer
Comparing Different Surgical Aproaches in Stage IB1 Cervical Cancer
(SUCCOR) database with FIGO 2009 IB1 cervical carcinoma treated with
radical hysterectomy between January 1, 2013, and December 31, 2014. We
used propensity score matching to minimize the potential allocation
biases arising from the retrospective design. Patients who underwent
conization but were similar for other measured characteristics were
matched 1:1 to patients from the non-cone group using a caliper width <=
0.2 standard deviations of the logit odds of the estimated propensity
score. Results We obtained a weighted cohort of 374 patients (187
patients with prior conization and 187 non-conization patients). We
found a 65% reduction in the risk of relapse for patients who had
cervical conization prior to radical hysterectomy (hazard ratio (HR)
0.35, 95% confidence interval (CI) 0.16 to 0.75, p=0.007) and a 75%
reduction in the risk of death for the same sample (HR 0.25, 95% CI
0.07 to 0.90, p=0.033). In addition, patients who underwent minimally
invasive surgery without prior conization had a 5.63 times higher chance
of relapse compared with those who had an open approach and previous
conization (HR 5.63, 95% CI 1.64 to 19.3, p=0.006). Patients who
underwent minimally invasive surgery with prior conization and those who
underwent open surgery without prior conization showed no differences in
relapse rates compared with those who underwent open surgery with prior
cone biopsy (reference) (HR 1.94, 95% CI 0.49 to 7.76, p=0.349 and HR
2.94, 95% CI 0.80 to 10.86, p=0.106 respectively). Conclusions In this
retrospective study, patients undergoing cervical conization before
radical hysterectomy had a significantly lower risk of relapse and
death