J Gynecol Oncol.  2018 Mar;29(2):e23. 10.3802/jgo.2018.29.e23.

Impact of institutional accreditation by the Japan Society of Gynecologic Oncology on the treatment and survival of women with cervical cancer

• Mikami M
• Shida M
• Shibata T
• Katabuchi
• Kigawa J
• Aoki D
• Yaegashi N

• KMID: 2404018
• DOI: http://doi.org/10.3802/jgo.2018.29.e23

Abstract

OBJECTIVE
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.
METHODS
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).
RESULTS
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).
CONCLUSION
Successful implementation of gynecologic oncology accrediting institution was associated with improved survival outcome of women with cervical cancer in Japan.

Keyword

Uterine Cervical Neoplasms; General Surgery; Surgical Procedures, Operative; Gyenecologic Oncologist; Specialization; Fellowship Training

MeSH Terms

Accreditation*
Certification
Education
Female
Gynecology
Humans
Japan*
Mortality
Multivariate Analysis
Obstetrics
Radiotherapy
Surgical Procedures, Operative
Uterine Cervical Neoplasms*