2.3 Outcomes
The primary outcome measures were recurrence, disease-free survival (DFS), and overall survival (OS). Recurrence was defined as histologically confirmed recurrence during follow-up. DFS was defined as date of surgery to date of first recurrence or last follow-up date. OS was defined as date of surgery to date of death or last follow-up date for patients who were still alive (1 February 2022). Secondary outcome measures were site of recurrence and manipulator preference in relation to the type of hospital. Site of recurrence was categorized as local, regional, or distant according to the site of first recurrence. Local recurrences included vaginal recurrences. Regional recurrences referred to pelvic recurrences, including pelvic lymph node involvement and spread to the vulva, rectum, urethra, or bladder, as well as paraaortic and iliac lymph node involvement. Distant recurrences were defined as extra-pelvic recurrences, including peritoneal carcinomatosis, omental metastasis, involvement of other lymph node stations, and metastasis to bowels, lung, liver, bone, or muscle. Type of hospital was defined as general, teaching hospital or academic.