Patient characteristics and survival by learning phases
Table 1 shows the baseline characteristics of the patients treated during the two phases. Apart from follow-up duration no significant differences were found. The median follow-up duration was 62 months (range 14-132 months) in group 1 (case 1-61) and 43 months (range 3-91 months) in group 2 (case 62-165) (P < 0.001). In both groups the majority of patients completed a three-year follow up (90.2% in group 1 vs. 80.8% in group 2, P = 0.168).
In total, 20 patients (12.1%) were diagnosed with recurrent disease within five years; 12 patients (19.7%) in group 1 and eight patients (7.7%) in group 2 (P = 0.028). In both group 1 and group 2 seven patients presented with locoregional recurrence (11.5% and 6.7%, respectively), four patients in group 1 (6.6%) and no patient in group 2 presented with distant recurrence and one patient in both group 1 and group 2 presented with a combination of locoregional and distant recurrence (1.6% and 1.0%, respectively). The 5-year DFS was 80.2% in group 1 and 91.1% in group 2 (P = 0.040) (Figure 2A). The 3-year DFS did not differ significantly between the groups (83.6% vs 92.8%,P = 0.064). Of the ten patients with recurrent disease who were alive at the time of analysis, five were treated curatively (three in group 1 and two in group 2) and five patients are currently on palliative treatment.
A total of 12 patients died within five years follow up, ten of whom died of cervical cancer; nine patients (14.8%) in group 1 and one patient (1.0%) in group 2. Both the DSS and OS at five years of follow up differed significantly between the two groups, in favour of group 2: 84.7% vs 97.7% (P = 0.002) (Figure 2B) and 84.7% vs 94.8% (P = 0.018) (Figure 2C), respectively.