Evidence map›Paper›PMID 29385139›Full record

SynthesisPloS one2018

Can simple trachelectomy or conization show comparable survival rate compared with radical trachelectomy in IA1 cervical cancer patients with lymphovascular space invasion who wish to save fertility? A systematic review and guideline recommendation.

Seung-Hyuk Shim, Myong Cheol Lim, Hyun Jung Kim, Maria Lee, Eun Ji Nam, Jung Yun Lee, Yoo-Young Lee, Kwang Beom Lee, Jeong Yeol Park, Yun Hwan Kim and 8 more

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Outcome and Subsequent Pregnancy after Fertility-Sparing Surgery of Early-Stage Cervical Cancers.International journal of environmental research and public health · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 10 institutions in 2 countries.

Seung-Hyuk ShimDepartment of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, Korea.
Myong Cheol LimCancer Healthcare Research Branch, Center for Uterine Cancer, and Center for Clinical Trials, Research Institute and Hospital, Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Ilsan-ro, Ilsandong-gu, Goyang-si Gyeonggi-do, Republic of Korea.
Hyun Jung KimDepartment of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
Maria LeeDepartment of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Eun Ji NamDepartment of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
Jung Yun LeeDepartment of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
Yoo-Young LeeDivision of Gynecologic Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
Kwang Beom LeeDepartment of Obstetrics and Gynecology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Jeong Yeol ParkDepartment of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Yun Hwan KimDepartment of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
Kyung Do KiDepartment of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
Yong Jung SongDepartment of Obstetrics and Gynecology, Pusan National University School of Medicine, Pusan, Korea.
Hyun Hoon ChungDepartment of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Sunghoon KimDepartment of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
Jeong-Won LeeDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jae-Weon KimDepartment of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Duk-Soo BaeDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jong-Min LeeDepartment of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
Yonsei University · KRSeoul National University · KRUlsan College · KRUniversity Health Network · CAEwha Womans University · KRKonkuk University · KRKorea University · KRKyung Hee University Hospital at Gangdong · KRNational Cancer Center · KRSamsung Medical Center · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aims to analyze the published literatures on the effect of less radical fertility-preserving procedures, such as conization or simple trachelectomy, on oncological outcomes in IA1 cervical cancer patients with lymphovascular space invasion (LVSI) through a systematic-review.

methodsThe EMBASE and MEDLINE databases and Cochrane Library were searched for published studies reporting the oncological outcomes of conization/simple trachelectomy in these patients, through April 2017. The endpoints were recurrence and mortality rates. Data were presented as per the Meta-analysis Of Observational Studies in Epidemiology checklist. Practice guidelines were generated via the Grading of Recommendation, Assessment, Development and Evaluation system.

resultsFrom 6,755 records, 94 full-texts articles were reviewed for eligibility, and five studies were included in this systematic review. All included studies were nonrandomized studies: two case-control studies comparing conization (n = 14) with hysterectomy (n = 24), and the other three were interrupted time series including conization (n = 20) and simple vaginal trachelectomy (n = 59). During the median follow-up duration of 43 months, no recurrence was reported in both conization and simple trachelectomy groups in IA1 patients with LVSI. From three studies reporting the fertility outcomes, the rates of pregnancy, live birth, preterm delivery, and second-trimester miscarriage were 73% (35/48), 64% (32/50), 10% (5/48), and 6% (3/48), respectively.

conclusionResults suggest that simple trachelectomy or conization could be performed for IA1 cervical cancer patients with LVSI who want to preserve fertility, although these results are only based on a small number of nonrandomized studies (recommendation grade 2 = weak; evidence level D = very low). Further randomized trials with long-term study period are needed to address this issue.

Indexed as

FertilityGuideline AdherenceSurvival RateAdultFemaleHumansLymphatic SystemNeoplasm InvasivenessPregnancyUterine Cervical Neoplasms

Identifiers

PMID29385139
PMCPMC5791938
OpenAlexW2790288566

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.