title: 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: OBJECTIVE
  To 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.
  
  
  METHODS
  Records 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.
  
  
  RESULTS
  There was no significant difference in median patient age (US 41.9 years [range 23-73] vs. Colombia 44.5 years [range 24-75], P=0.09). Patients in Colombia had a lower median body mass index than patients in the US (24.4 kg/m(2) vs. 28.7 kg/m(2), P=0.002). Compared to patients treated in Colombia, patients who underwent surgery in the US had a greater median estimated blood loss (200 mL vs. 79 mL, P<0.001), longer median operative time (328.5 min vs. 235 min, P<0.001), and longer postoperative hospital stay (2 days vs. 1 day, P<0.001).
  
  
  CONCLUSIONS
  Surgical 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.
authors.affiliation: Gynecology Oncology Unit, Instituto de Cancerología-Clínica las Américas, Medellín, Colombia.
authors.forename: Rene
authors.initials: R
authors.lastname: Pareja
authors.forename: Alpa M
authors.initials: AM
authors.lastname: Nick
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Schmeler
authors.forename: Michael
authors.initials: M
authors.lastname: Frumovitz
authors.forename: Pamela T
authors.initials: PT
authors.lastname: Soliman
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Buitrago
authors.forename: Mauricio
authors.initials: M
authors.lastname: Borrero
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Angel
authors.forename: Ricardo Dos
authors.initials: RD
authors.lastname: Reis
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
mesh_terms: D000328:Adult; D000368:Aged; D002173:Cancer Care Facilities / Q000592:standards*; D003105:Colombia; D003906:Developing Countries; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000592:standards*; D007391:International Cooperation; D010535:Laparoscopy / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult