Objective This article assesses the compliance of surgical management of carcinoma cervix, to the quality indicators for treatment put forth by the European Society of Gynaeacological Oncology (ESGO), at a tertiary care center.
Methods This is a retrospective analysis and audit of data collected from electronic medical records of patients with carcinoma cervix who underwent surgical management in the department of gynecologic oncology from June 1, 2017 to May 31, 2020.
Results Compliance to all 15 quality indicators under 5 categories was assessed. The first two structural indicators were met. The mean number of parametrectomies was 24 and all were operated by a specialist. With regard to targets addressing overall management, only 46% cases were preoperatively planned in multidisciplinary team meetings and 74% met the target of required preop investigations. There was deficiency in recording pertinent intraoperative details and postoperative pathological information. On assessing the quality of surgical care, there were no postoperative urological fistula, but 18% had involved surgical margins, 16% were upstaged postsurgery, and 15% had recurrence within 2 years. All were counseled about fertility-sparing technique when relevant but only 7% had undergone lymph node staging as per recommendations and 51% had received adjuvant chemoradiation.
Conclusion This audit revealed that the department did not meet the ESGO quality standards published in 2020. The department has implemented structural and procedural changes to meet these standards and a plan to continuously assess compliance to the same.
Keywords cervical cancer - clinical audits - compliance - quality measures - radical hysterectomy Ethical ApprovalThis study was approved by the institutional study board (IRB Min No: 12591). Given the retrospective nature of the study, patient consent was waived.
M.T. and V.T. conceived the study design. M.T., V.T., A.S., D.S.T., A.T., R.C., and A.P. were involved in data collection, analysis, interpretation, and conclusion. M.T. and V.T. prepared the manuscript which was reviewed and approved by all the coauthors. All authors have agreed to be responsible for the published research.
Publication HistoryReceived: 25 September 2023
Accepted: 02 July 2024
Article published online:
22 July 2024
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