Danish Gynecological Cancer Database

Sørensen, Sarah Mejer; Bjørn, Signe Frahm; Jochumsen, Kirsten Marie; Jensen, Pernille Tine; Thranov, Ingrid; Hare-Bruun, Helle; Seibæk, Lene; Høgdall, Claus

doi:10.2147/clep.s99479

Cited by 61 publications

(59 citation statements)

References 10 publications

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“…The Danish Gynecological Cancer Database (DGCD) 2005–12 includes almost all 4707 Danish patients with endometrial cancer diagnosed during the period January 1, 2005 to December 31, 2012 11. A validation study of the DGCD endometrial cancer patients demonstrated valid data especially if reported by pathologists 12.…”

Section: Methodsmentioning

confidence: 99%

Location of recurrences in high-risk stage Iendometrial cancer patients not given postoperative radiotherapy: A Danish gynecological cancer group study

Ørtoft

Høgdall

Juhl

et al. 2019

Int J Gynecol Cancer

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ObjectivesTo study recurrence rates in Danish high-risk stage I endometrial cancers not given radiotherapy in accordance with the decision of the Danish Gynecological Cancer Group.MethodsThis prospective national cohort study includes all 4707 endometrial carcinomas diagnosed from 2005 to 2012. Of these, 623 patients had grade 3 endometroid adenocarcinoma with >50% myometrial invasion or serous/clear/undifferentiated carcinoma (with any depth of invasion). In 305 patients with high-risk stage I on final pathology, 14.1% received adjuvant external beam radiotherapy and 9.6% adjuvant chemotherapy. No patients received brachytherapy. 5-year Kaplan-Meier survival estimates and actuarial recurrence rates were calculated, and adjusted Cox regression analysis used for comparison. Recurrence rates were compared with historical Danish population data (DEMCA 98–99).ResultsFor non-irradiated patients, 5-year overall survival, cancer-specific survival, and progression-free survival rates in high-risk stage I patients were 65%, 78%, and 73%, respectively. For non-irradiated patients, isolated local recurrences were uncommon (vaginal 3.1%, pelvic 0.4%). Death was mainly due to a high occurrence of non-local recurrences, with 8.8% experiencing a first recurrence in the abdominal cavity (outside the field where radiation traditionally have been given) and 13.0% a distant metastasis outside the abdominal cavity. Grade 3 tumors with >50% myometrial invasion seem to be characterized by a different pattern of recurrences, with significantly more isolated vaginal recurrences (7.9% vs 2.2%) and fewer total number of abdominal recurrences (7.9% vs 15.3%) as compared with unfavorable tumor types.ConclusionIsolated vaginal and pelvic recurrences were rare (3–5%) in patients with a final pathologic diagnosis of high-risk stage I endometrial cancer even after the Danish Gynecological Cancer Group decided to omit all types of postoperative radiotherapy and introduce lymph node staging.

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Section: Methodsmentioning

confidence: 99%

Location of recurrences in high-risk stage Iendometrial cancer patients not given postoperative radiotherapy: A Danish gynecological cancer group study

Ørtoft

Høgdall

Juhl

et al. 2019

Int J Gynecol Cancer

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“…Thus, according to the latest annual report (July 1, 2015YJune 30, 2016), 1853 gynecological cancer pathways were registered during this period, representing a national coverage of 89% in this period. 2 The DGCD Nursing holds a total of 436 variables. In the following, a selection of examples will be presented to illustrate the potential of the database: Table 1 displays the data entry in relation to registration period and cancer type.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, an annual report 11 presenting a number of clinical quality indicators are developed by the DGCD steering committee in close cooperation with the national registry support center. 2 In accordance with the current legislation on data protection, real-time data are entered by the clinical nurses at each cancer center in an ongoing process. Subsequently, duration of hospitalization and postoperative complications are added from the National Patient Registry, and survival data are extracted from the Civil Registration System, which is updated on a day-to-day basis.…”

Section: Methodsmentioning

confidence: 99%

“…The database was established in 2005 and includes data on all Danish women treated for cancer of the ovaries, peritoneum, fallopian tubes, vulva, vagina, cervix, and uterus. 2 In Denmark, the National Health Service delivers free cancer treatment and care for all citizens in 5 politically run regions. All citizens have a unique Civil Registration Number, which makes it possible to link individual data from across a wide range of national databases.…”

mentioning

confidence: 99%

“…8 On this background, a group of expert nurse representatives from all national cancer centers in close cooperation with the DGCD steering committee established a national nursing database (DGCD Nursing), which was integrated into the existing DGCD. 2,9 The DGCD Nursing includes data on preoperative and postoperative care equal to biomedical data and nurses are independently represented in the steering committee. To our knowledge, DGCD Nursing is the first nationwide nursing database directly connected to a general clinical cancer database.…”

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confidence: 99%

See 2 more Smart Citations

The Danish Gynecological Cancer Nursing Database: Creating Evidence for Quality Improvements in Preoperative and Postoperative Cancer Care

Seibæk

Jakobsen

Høgdall

2018

Int J Gynecol Cancer

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At national level, DGCD offers a comprehensive overview of the total patient pathway within gynecological cancer surgery. The DGCD Nursing has added to the quality and implementation of evidence-based preoperative and postoperative care and in addition supported formation of professional networks. With a continued validation of data, DGCD Nursing now constitutes a sound and unique basis for research within the field of preoperative and postoperative cancer care.

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Nationwide Introduction of Minimally Invasive Robotic Surgery for Early-Stage Endometrial Cancer and Its Association With Severe Complications

Jørgensen

Mogensen

et al. 2019

JAMA Surg

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IMPORTANCE Minimally invasive laparoscopic surgery (MILS) for endometrial cancer reduces surgical morbidity compared with a total abdominal hysterectomy. However, only a minority of women with early-stage endometrial cancer undergo MILS. OBJECTIVE To evaluate the association between the Danish nationwide introduction of minimally invasive robotic surgery (MIRS) and severe complications in patients with early-stage endometrial cancer. DESIGN, SETTING, AND PARTICIPANTS In this nationwide prospective cohort study of 5654 women with early-stage endometrial cancer who had undergone surgery during the period from January 1, 2005, to June 30, 2015, data from the Danish Gynecological Cancer Database were linked with national registers on socioeconomic status, deaths, hospital diagnoses, and hospital treatments. The women were divided into 2 groups; group 1 underwent surgery before the introduction of MIRS in their region, and group 2 underwent surgery after the introduction of MIRS. Women with an unknown disease stage, an unknown association with MIRS implementation, unknown histologic findings, sarcoma, or synchronous cancer were excluded, as were women who underwent vaginal or an unknown surgical type of hysterectomy. Statistical analysis was conducted from February 2, 2017, to May 4, 2018. EXPOSURE Minimally invasive robotic surgery, MILS, or total abdominal hysterectomy. MAIN OUTCOMES AND MEASURES Severe complications were dichotomized and encompassed death within 30 days after surgery and intraoperative and postoperative complications diagnosed within 90 days after surgery. RESULTS A total of 3091 women (mean [SD] age, 67 [10] years) were allocated to group 1, and a total of 2563 women (mean [SD] age, 68 [10] years) were allocated to group 2. In multivariate logistic regression analyses, the odds of severe complications were significantly higher in group 1 than in group 2 (odds ratio [OR], 1.39; 95% CI, 1.11-1.74). The proportion of women undergoing MILS was 14.1% (n = 436) in group 1 and 22.2% in group 2 (n = 569). The proportion of women undergoing MIRS in group 2 was 50.0% (n = 1282). In group 2, multivariate logistic regression analyses demonstrated that a total abdominal hysterectomy was associated with increased odds of severe complications compared with MILS (OR, 2.58; 95% CI, 1.80-3.70) and MIRS (OR, 3.87; 95% CI, 2.52-5.93). No difference was found for MILS compared with MIRS (OR, 1.50; 95% CI, 0.99-2.27). CONCLUSIONS AND RELEVANCE The national introduction of MIRS changed the surgical approach for early-stage endometrial cancer from open surgery to minimally invasive surgery. This change in surgical approach was associated with a significantly reduced risk of severe complications.

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Danish Gynecological Cancer Database

Cited by 61 publications

References 10 publications

Location of recurrences in high-risk stage Iendometrial cancer patients not given postoperative radiotherapy: A Danish gynecological cancer group study

Location of recurrences in high-risk stage Iendometrial cancer patients not given postoperative radiotherapy: A Danish gynecological cancer group study

The Danish Gynecological Cancer Nursing Database: Creating Evidence for Quality Improvements in Preoperative and Postoperative Cancer Care

Nationwide Introduction of Minimally Invasive Robotic Surgery for Early-Stage Endometrial Cancer and Its Association With Severe Complications

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