Definitions and outcome measures
In this study, patients treated by surgeons with different LRH experiences were divided into three groups14: low-volume surgeons (< 51), mid-volume surgeons (51-100) and high-volume surgeons (> 100). Outcome measures included operative technique (operative time and blood loss) and oncological outcome (5-year OS and DFS).
OS was defined as the time from the date of surgery to the date of death from any cause. DFS was defined as the time from the date of surgery to the date of disease recurrence or death from cervical cancer, and patients with no evidence of recurrence or death were censored at the date of the last follow-up or return visit.
According to FIGO guidelines15, standard postoperative treatment was defined by any one pathological high-risk factor (positive para-aortic or pelvic nodes, parametrial extension, and positive margins) or any two or more pathological medium-risk factors (tumor size > 4 cm, LVSI, stromal invasion) who received radiotherapy or radiochemotherapy or those with no postoperative high-risk factor and one or more medium-risk factors who did not receive postoperative radiotherapy or radiochemotherapy.