The Canadian Cervical Cancer Collaborative represents a database of 11 tertiary institutions across Canada, capturing all cases of surgically treated cervical carcinoma from January 2007 to December 2017. All participating sites had approval from their local Research Ethics Boards.
Inclusion criteria were age > 18 years old, squamous, adenocarcinoma, or adenosquamous histology cervical carcinoma, and primary surgical treatment. Surgical approach included both simple and radical hysterectomies performed by laparotomy, laparoscopic or robotic, or laparoscopically assisted vaginal or vaginal hysterectomy. Only patients with nodal evaluation (sentinel lymph node biopsy or lymphadenectomy) were included in the present study. For this study, all patients had to have no residual carcinoma on final hysterectomy specimen. Indication for excisional procedure was not collected, but all cases had a diagnosis of cervical carcinoma prior to definitive surgical treatment. Cases were excluded if they underwent neoadjuvant radiation therapy or chemotherapy, were stage IA1 without LVSI, stage IV, underwent trachelectomy or conization as their definitive surgery, tumors > 4 cm (by clinical exam or imaging- pre-conization), “other” histologies, or with missing pertinent information (tumor size, surgical type, final stage).
Staging was based on the pathological FIGO 2018 staging system. Recurrences were determined on the basis of either radiographic evidence or biopsy-proven recurrence. Follow up was in accordance with local standard of care. Data were collected locally at each institution and entered into a central REDCap database. Data collected included demographics (age, smoking status, ASA score, height, weight and BMI calculation), preoperative imaging (MRI and/or PET scan), operative factors (mode of surgery, lymph node assessment, uterine manipulator, complication), postoperative factors (length of stay, readmission), pathologic characteristics (FIGO 2018 pathologic staging, histology, tumor diameter, stromal invasion, lymphovascular space invasion, lymph node status, and adjuvant treatment (chemotherapy and radiotherapy), along with recurrence and follow up data.
Descriptive statistics were used to summarize demographic, treatment, and disease variables, as well as outcomes. Chi-square, Wilcoxon rank sum, and log-rank tests were used to explore for differences in characteristics based on surgical technique, as well as the potential effect of surgery on outcomes of interest. Recurrence free survival (RFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Given the small number of disease-specific events, no regression analysis was performed. All analyses and confidence intervals were two-sided and statistical significance was defined at the α = 0.05 level. SAS version 9 statistical software package was used for analysis.
Inclusion criteria were age > 18 years old, squamous, adenocarcinoma, or adenosquamous histology cervical carcinoma, and primary surgical treatment. Surgical approach included both simple and radical hysterectomies performed by laparotomy, laparoscopic or robotic, or laparoscopically assisted vaginal or vaginal hysterectomy. Only patients with nodal evaluation (sentinel lymph node biopsy or lymphadenectomy) were included in the present study. For this study, all patients had to have no residual carcinoma on final hysterectomy specimen. Indication for excisional procedure was not collected, but all cases had a diagnosis of cervical carcinoma prior to definitive surgical treatment. Cases were excluded if they underwent neoadjuvant radiation therapy or chemotherapy, were stage IA1 without LVSI, stage IV, underwent trachelectomy or conization as their definitive surgery, tumors > 4 cm (by clinical exam or imaging- pre-conization), “other” histologies, or with missing pertinent information (tumor size, surgical type, final stage).
Staging was based on the pathological FIGO 2018 staging system. Recurrences were determined on the basis of either radiographic evidence or biopsy-proven recurrence. Follow up was in accordance with local standard of care. Data were collected locally at each institution and entered into a central REDCap database. Data collected included demographics (age, smoking status, ASA score, height, weight and BMI calculation), preoperative imaging (MRI and/or PET scan), operative factors (mode of surgery, lymph node assessment, uterine manipulator, complication), postoperative factors (length of stay, readmission), pathologic characteristics (FIGO 2018 pathologic staging, histology, tumor diameter, stromal invasion, lymphovascular space invasion, lymph node status, and adjuvant treatment (chemotherapy and radiotherapy), along with recurrence and follow up data.
Descriptive statistics were used to summarize demographic, treatment, and disease variables, as well as outcomes. Chi-square, Wilcoxon rank sum, and log-rank tests were used to explore for differences in characteristics based on surgical technique, as well as the potential effect of surgery on outcomes of interest. Recurrence free survival (RFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Given the small number of disease-specific events, no regression analysis was performed. All analyses and confidence intervals were two-sided and statistical significance was defined at the α = 0.05 level. SAS version 9 statistical software package was used for analysis.
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