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.