Quality of laparoscopic radical hysterectomy in developing countries: A comparison of surgical and oncologic outcomes between a comprehensive cancer center in the United States and a cancer center in Colombia

Abstract

ObjectiveTo help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a cancer center in Colombia. MethodsRecords of the first 50 consecutive patients who underwent laparoscopic radical hysterectomy at The University of Texas MD Anderson Cancer Center in Houston (between April 2004 and July 2007) and the first 50 consecutive patients who underwent the same procedure at the Instituto de Cancerología–Clínica las Américas in Medellín (between December 2008 and October 2010) were retrospectively reviewed. Surgical and oncologic outcomes were compared between the 2 groups. ResultsThere was no significant difference in median patient age (US 41.9years [range 23–73] vs. Colombia 44.5years [range 24–75], P=0.09). Patients in Colombia had a lower median body mass index than patients in the US (24.4kg/m2 vs. 28.7kg/m2, P=0.002). Compared to patients treated in Colombia, patients who underwent surgery in the US had a greater median estimated blood loss (200mL vs. 79mL, P<0.001), longer median operative time (328.5min vs. 235min, P<0.001), and longer postoperative hospital stay (2days vs. 1day, P<0.001). ConclusionsSurgical and oncologic outcomes of laparoscopic radical hysterectomy were not worse at a cancer center in a developing country than at a large comprehensive cancer center in the United States. These results support consideration of developing countries for inclusion in collaborations for prospective surgical studies.