Characteristic | Abdominal surgeon volume | P value | Laparoscopic surgeon volume | P value | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Low | Intermediate | High | Low | Intermediate | High | |||||||||
Patients | 4837 | 33.3 | 4913 | 33.8 | 4786 | 32.9 | 2642 | 32.4 | 2637 | 32.4 | 2869 | 35.2 | ||
Surgeons | 361 | 44 | 22 | 212 | 33 | 18 | ||||||||
Annualized hospital volume | 2.0 (1.0–3.5) | 10.8 (9.1–12.5) | 30.9 (21.9–42.1) | 2.3 (1.0–5.0) | 13.5 (12.3–16.9) | 27.8 (21.6–30.1) | ||||||||
Range | 1.0 | 8.1 | 8.2 | 16.9 | 17.0 | 129.4 | 1.0 | 11.0 | 11.1 | 20.0 | 20.1 | 51.7 | ||
Age at surgery, years | ||||||||||||||
≥ 60 | 444 | 9.2 | 515 | 10.5 | 798 | 16.7 | < 0.001 | 257 | 9.7 | 299 | 11.3 | 346 | 12.1 | 0.02 |
< 60 | 4393 | 90.8 | 4398 | 89.5 | 3988 | 83.3 | 2385 | 90.3 | 2338 | 88.7 | 2523 | 87.9 | ||
Year of diagnosis | ||||||||||||||
2004–2009 | 1736 | 35.9 | 1748 | 35.6 | 245 | 5.1 | < 0.001 | 149 | 5.6 | 46 | 1.7 | 59 | 2.1 | < 0.001 |
2010–2016 | 3101 | 64.1 | 3165 | 64.4 | 4541 | 94.9 | 2493 | 94.4 | 2591 | 98.3 | 2810 | 97.9 | ||
Urban‒rural distribution | ||||||||||||||
Rural | 2316 | 47.9 | 2988 | 60.8 | 3098 | 64.7 | < 0.001 | 1572 | 59.5 | 1450 | 55.0 | 1638 | 57.1 | < 0.001 |
Urban | 1423 | 29.4 | 1539 | 31.3 | 1004 | 21.0 | 739 | 28.0 | 959 | 36.4 | 1055 | 36.8 | ||
Unknown | 1098 | 22.7 | 386 | 7.9 | 684 | 14.3 | 331 | 12.5 | 228 | 8.6 | 176 | 6.1 | ||
Hospital function | ||||||||||||||
General hospital | 3451 | 71.3 | 2893 | 58.9 | 641 | 13.4 | < 0.001 | 1998 | 75.7 | 2097 | 79.5 | 1526 | 53.2 | < 0.001 |
Cancer centre | 1088 | 22.5 | 1626 | 33.1 | 4145 | 86.6 | 450 | 17.0 | 386 | 14.6 | 1223 | 42.6 | ||
W&C centre | 298 | 6.2 | 394 | 8.0 | 0 | 0.0 | 194 | 7.3 | 154 | 5.8 | 120 | 4.2 | ||
Region | ||||||||||||||
North | 724 | 15.0 | 1292 | 26.3 | 2784 | 58.2 | < 0.001 | 589 | 22.3 | 220 | 8.3 | 605 | 21.1 | < 0.001 |
South | 1380 | 28.5 | 1095 | 22.3 | 531 | 11.1 | 688 | 26.1 | 427 | 16.2 | 120 | 4.2 | ||
Central | 618 | 12.8 | 410 | 8.3 | 1169 | 24.4 | 350 | 13.2 | 700 | 26.5 | 231 | 8.1 | ||
East | 1490 | 30.8 | 1013 | 20.6 | 302 | 6.3 | 752 | 28.5 | 396 | 15.0 | 0 | 0.0 | ||
Southwest | 307 | 6.3 | 335 | 6.8 | 0 | 0.0 | 91 | 3.4 | 507 | 19.2 | 1808 | 63.0 | ||
Northwest | 158 | 3.3 | 668 | 13.6 | 0 | 0.0 | 161 | 6.1 | 323 | 12.2 | 105 | 3.7 | ||
Northeast | 160 | 3.3 | 100 | 2.0 | 0 | 0.0 | 11 | 0.4 | 64 | 2.4 | 0 | 0.0 | ||
City scale | ||||||||||||||
First-tier | 773 | 16.0 | 745 | 15.2 | 529 | 11.1 | < 0.001 | 560 | 21.2 | 299 | 11.3 | 0 | 0.0 | < 0.001 |
Second-tier | 2458 | 50.8 | 2885 | 58.7 | 3986 | 83.3 | 1471 | 55.7 | 1916 | 72.7 | 2362 | 82.3 | ||
Third-tier | 1606 | 33.2 | 1283 | 26.1 | 271 | 5.7 | 611 | 23.1 | 422 | 16.0 | 507 | 17.7 | ||
Mode of delivery | ||||||||||||||
No delivery | 49 | 1.0 | 57 | 1.2 | 22 | 0.5 | < 0.001 | 23 | 0.9 | 23 | 0.9 | 36 | 1.3 | < 0.001 |
Vaginal delivery | 3684 | 76.2 | 4026 | 81.9 | 4059 | 84.8 | 2114 | 80.0 | 2157 | 81.8 | 2541 | 88.6 | ||
Caesarean delivery | 253 | 5.2 | 291 | 5.9 | 221 | 4.6 | 194 | 7.3 | 243 | 9.2 | 261 | 9.1 | ||
Unknown | 851 | 17.6 | 539 | 11.0 | 484 | 10.1 | 311 | 11.8 | 214 | 8.1 | 31 | 1.1 | ||
Comorbidity | ||||||||||||||
No | 4526 | 93.6 | 4592 | 93.5 | 4242 | 88.6 | < 0.001 | 2425 | 91.8 | 2436 | 92.4 | 2611 | 91.0 | 0.18 |
Yes | 311 | 6.4 | 321 | 6.5 | 544 | 11.4 | 217 | 8.2 | 201 | 7.6 | 258 | 9.0 | ||
FIGO stage | ||||||||||||||
IA1 + IA2 | 133 | 2.7 | 76 | 1.5 | 30 | 0.6 | < 0.001 | 70 | 2.7 | 49 | 1.9 | 45 | 1.6 | < 0.001 |
IB1 | 2288 | 47.3 | 2117 | 43.1 | 2282 | 47.7 | 1554 | 58.8 | 1323 | 50.2 | 1318 | 45.9 | ||
IB2 | 656 | 13.6 | 690 | 14.0 | 531 | 11.1 | 289 | 10.9 | 295 | 11.2 | 328 | 11.4 | ||
IIA1 | 679 | 14.0 | 680 | 13.8 | 1278 | 26.7 | 350 | 13.2 | 329 | 12.5 | 586 | 20.4 | ||
IIA2 | 297 | 6.1 | 324 | 6.6 | 478 | 10.0 | 123 | 4.7 | 176 | 6.7 | 270 | 9.4 | ||
IIB | 784 | 16.2 | 1026 | 20.9 | 187 | 3.9 | 256 | 9.7 | 465 | 17.6 | 322 | 11.2 | ||
Gross type | ||||||||||||||
Exophytic | 2585 | 53.4 | 2854 | 58.1 | 2058 | 43.0 | < 0.001 | 1287 | 48.7 | 1357 | 51.5 | 1540 | 53.7 | < 0.001 |
Endophytic | 276 | 5.7 | 316 | 6.4 | 1528 | 31.9 | 128 | 4.8 | 73 | 2.8 | 185 | 6.4 | ||
Ulcerated | 900 | 18.6 | 790 | 16.1 | 550 | 11.5 | 461 | 17.4 | 467 | 17.7 | 699 | 24.4 | ||
Endocervical | 105 | 2.2 | 64 | 1.3 | 29 | 0.6 | 45 | 1.7 | 39 | 1.5 | 44 | 1.5 | ||
After conization | 132 | 2.7 | 106 | 2.2 | 74 | 1.5 | 80 | 3.0 | 97 | 3.7 | 102 | 3.6 | ||
Preclinical carcinoma | 342 | 7.1 | 414 | 8.4 | 178 | 3.7 | 298 | 11.3 | 256 | 9.7 | 140 | 4.9 | ||
Unknown | 497 | 10.3 | 369 | 7.5 | 369 | 7.7 | 343 | 13.0 | 348 | 13.2 | 159 | 5.5 | ||
Histological types | ||||||||||||||
Squamous cell | 4178 | 86.4 | 4326 | 88.1 | 4301 | 89.9 | < 0.001 | 2252 | 85.2 | 2223 | 84.3 | 2481 | 86.5 | 0.008 |
Adenocarcinoma | 450 | 9.3 | 397 | 8.1 | 294 | 6.1 | 262 | 9.9 | 293 | 11.1 | 272 | 9.5 | ||
Adenosquamous | 113 | 2.3 | 92 | 1.9 | 94 | 2.0 | 45 | 1.7 | 54 | 2.0 | 49 | 1.7 | ||
Other subtypes | 81 | 1.7 | 90 | 1.8 | 89 | 1.9 | 48 | 1.8 | 43 | 1.6 | 56 | 2.0 | ||
Unknown | 15 | 0.3 | 8 | 0.2 | 8 | 0.2 | 35 | 1.3 | 24 | 0.9 | 11 | 0.4 | ||
Preoperative treatment | ||||||||||||||
No received | 3457 | 71.5 | 3565 | 72.6 | 3911 | 81.7 | < 0.001 | 2038 | 77.1 | 2098 | 79.6 | 2164 | 75.4 | < 0.001 |
Neoadjuvant chemotherapy | 1243 | 25.7 | 970 | 19.7 | 594 | 12.4 | 557 | 21.1 | 449 | 17.0 | 667 | 23.2 | ||
Preoperative radiotherapy | 137 | 2.8 | 378 | 7.7 | 281 | 5.9 | 47 | 1.8 | 90 | 3.4 | 38 | 1.3 | ||
Lymph node dissection | ||||||||||||||
PLA | 4651 | 96.2 | 4604 | 93.7 | 4735 | 98.9 | < 0.001 | 2269 | 85.9 | 2028 | 76.9 | 1905 | 66.4 | < 0.001 |
PLA + PALA | 186 | 3.8 | 309 | 6.3 | 51 | 1.1 | 373 | 14.1 | 609 | 23.1 | 964 | 33.6 | ||
Hysterectomy types | ||||||||||||||
Type B | 2852 | 59.0 | 2140 | 43.6 | 3340 | 69.8 | < 0.001 | 1047 | 39.6 | 592 | 22.4 | 242 | 8.4 | < 0.001 |
Type C2 | 1962 | 40.6 | 2719 | 55.3 | 1424 | 29.7 | 1558 | 59.0 | 1991 | 75.5 | 2616 | 91.2 | ||
Type C1 | 23 | 0.5 | 54 | 1.1 | 22 | 0.5 | 37 | 1.4 | 54 | 2.0 | 11 | 0.4 | ||
Operation time (min) | 232.8 ± 64.8 | 205.0 ± 55.4 | 164.7 ± 52.8 | < 0.001 | 259.6 ± 77.1 | 234.4 ± 70.8 | 209.6 ± 64.6 | < 0.001 | ||||||
Blood loss (ml) | 499.2 ± 363.1 | 470.3 ± 375.14 | 241.0 ± 211.6 | < 0.001 | 216.2 ± 305.7 | 193.0 ± 188.6 | 185.1 ± 170.1 | < 0.001 |