Surgical outcome of endoscopic surgery in women with early stage cervical and endometrial carcinoma, the role of surgeon's experience and quality parameters

Introduction: Endoscopical treatment of early stage cervical and endometrial carcinoma has become an oncologically safe treatment option during the last decade. But for many centers it is still a challenge and only few surgeons perform this procedure. The aim of this study was to assess the impact of surgeon's experience on the surgical outcome in women with early stage cervical and endometrial carcinoma using specific quality parameters.

Material and methods: Between 10/2009 and 12/2013, 250 patients with early stage cervical and endometrial carcinoma who underwent endoscopical treatment at our high-volume hospital in Homburg/Saar were included in the study. The procedures were performed by four experienced surgeons and one assisting resident physician each. Demographic data, intraoperative findings and the postoperative outcome were evaluated. All data were collected in a database and reviewed retrospectively. The investigated time period was divided in 3 equal time periods.

Results: A first evaluation of the data of 150 out of 250 patients (84 endometrial carcinoma and 66 cervical carcinoma) is available. A decrease in operating time, a decrease in complication rate and an increase in the number of pelvic and paraaortic lymph nodes harvested could be shown with increasing surgeon's experience.

Conclusion: Our findings should encourage centers to adopt minimal invasive strategies in gynecological oncology.