Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan.
Department of Molecular Life Science, Tokai University School of Medicine, Isehara, Japan.
J Gynecol Oncol. 2018 Mar;29(2):e23. doi: 10.3802/jgo.2018.29.e23. Epub 2017 Dec 27.
The Japan Society of Gynecologic Oncology (JSGO) initiated a nation-wide training system for the education and certification for gynecologic oncologists in 2005. To assess the impact of the quality of the JSGO-accredited institutions, JSGO undertook an analysis of the Uterine Cervical Cancer Registry of the Japan Society of Obstetrics and Gynecology (JSOG) to determine the effectiveness of the JSGO-accredited institutions on the treatment and survival of women with cervical cancer.
The effectiveness of 119 JSGO-accredited institutions and 125 non-JSGO-accredited institutions on the treatment and survival of women with cervical cancer were compared by analyzing the tumor characteristics, treatment patterns, and survival outcomes of women with stage T1B-T4 cervical cancer utilizing the data in the JSOG nation-wide registry for cervical cancer (2006-2009).
A total of 14,185 eligible women were identified: 10,920 (77.0%) cases for 119 JSGO-accredited institutions and 3,265 (23.0%) cases for 125 non-accredited institutions. A multivariate analysis showed that age, stage, histology type, and treatment pattern were independently associated with mortality. Moreover, women who received treatment at the JSGO-accredited institutions had a significantly decreased mortality risk compared to non-accredited institutions (adjusted hazard ratio [aHR]=0.843; 95% confidence interval [CI]=0.784-0.905). Similar findings on multivariate analysis were seen among subset of women who received surgery alone (aHR=0.552; 95% CI=0.393-0.775) and among women who received radiotherapy (aHR=0.845; 95% CI=0.766-0.931).
Successful implementation of gynecologic oncology accrediting institution was associated with improved survival outcome of women with cervical cancer in Japan.
日本妇科肿瘤学会（JSGO）于 2005 年启动了一项针对妇科肿瘤医生的教育和认证的全国性培训系统。为了评估 JSGO 认证机构的质量影响，JSGO 对日本妇产科协会（JSOG）的子宫颈癌登记处进行了分析，以确定 JSGO 认证机构对宫颈癌患者治疗和生存的效果。
利用 JSOG 全国子宫颈癌登记处（2006-2009 年）的数据，分析了 T1B-T4 期宫颈癌患者的肿瘤特征、治疗模式和生存结果，比较了 119 家 JSGO 认证机构和 125 家非 JSGO 认证机构对宫颈癌患者的治疗和生存效果。
共确定了 14185 名符合条件的妇女：10920 例（77.0%）病例来自 119 家 JSGO 认证机构，3265 例（23.0%）病例来自 125 家非认证机构。多变量分析显示，年龄、分期、组织学类型和治疗模式与死亡率独立相关。此外，与非认证机构相比，在 JSGO 认证机构接受治疗的妇女死亡风险显著降低（调整后的危险比[aHR]=0.843；95%置信区间[CI]=0.784-0.905）。在接受单纯手术治疗的妇女亚组（aHR=0.552；95%CI=0.393-0.775）和接受放疗的妇女亚组（aHR=0.845；95%CI=0.766-0.931）也观察到了类似的多变量分析结果。
在日本，妇科肿瘤学认证机构的成功实施与宫颈癌患者生存结果的改善相关。
