Assessment of the European Society of Gynaecological Oncology quality indicators in cervical cancer surgery: Application in a single tertiary government hospital in the Philippines

Abstract BACKGROUND: Cervical cancer is a common malignancy among Filipino women, treated through surgery, chemotherapy, or radiation. To improve outcomes and reduce costs, the European Society of Gynaecological Oncology (ESGO) established 15 quality indicators for its surgical management. The aim of the study was to evaluate the quality of cervical cancer surgeries at a tertiary government hospital in the Philippines, using ESGO quality indicators. METHODS: A descriptive retrospective review was conducted on medical records of early-stage cervical cancer patients who underwent radical surgery from January 1, 2019, to December 31, 2021. Data were collected using ESGO’s 15 quality indicators. Incomplete records were excluded from the study. Descriptive statistics and Kaplan–Meier analysis were used. RESULTS: Fifty-four patients underwent surgery, averaging 18 cases per year. Most surgeries (75.93%) were supervised by certified gynecologic oncologists, and 85.2% were discussed in multidisciplinary conferences. All patients had appropriate preoperative assessments and metastatic imaging. Pathology reports met the required standards, and lymph node staging was achieved in all cases. Adequate lymph node harvest was 68.18% (pelvic) and 65.91% (paraaortic). Fertility counseling was provided, although none pursued fertility-sparing treatment. Surgical complications included two vesicovaginal fistulas (3.7%). Clear margins were achieved in 92.59%, with 24.30% upstaged postoperatively. Adjuvant chemoradiotherapy rates were highest in 2019 (93.33%). No recurrences were noted for stage IB1 after a median 34-month follow-up. CONCLUSION: The surgeries met ESGO quality standards, demonstrating that these indicators can be adapted locally, ensuring quality assurance in care.