Evidence map›Paper›PMID 30379613›Full record

ArticleThe New England journal of medicine2018

Survival after Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer.

Alexander Melamed, Daniel J Margul, Ling Chen, Nancy L Keating, Marcela G Del Carmen, Junhua Yang, Brandon-Luke L Seagle, Amy Alexander, Emma L Barber, Laurel W Rice and 4 more

2 registry-linked trialsOpen access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The New England journal of medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 337 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
337citing papers in PubMed, 7 pooled it
72.8field-weighted citation impact, top 1% 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.

NCT04999696 nanot yet recruitingnot on this mapstarted 2023, after this paper: background citation

Minimally Invasive Therapy Versus Open Radical Hysterectomy (MITOR) for Management of Early Stage Cervical Cancer

TypeinterventionalSponsorChang Gung Memorial HospitalRan2023 to 2033Enrolled820ConditionsCancer of Cervix, Laparoscopic SurgeryArmsradical hysterectomy
NCT06790004 active not recruitingnot on this mapstarted 2021, after this paper: background citation

Endometrial Carcinoma: Comparison of Surgical Approaches (Laparoscopy vs Laparotomy) : Multicenter Retrospective Observational Study

TypeobservationalSponsorAzienda USL Reggio Emilia - IRCCSRan2021 to 2026Enrolled700ConditionsEndometrial CarcinomaArmsLaparotomy, Laparoscopy
3 · Its place in the literature

Who cites it

337 citing papers in PubMed, 7 syntheses or guidelines pooled it, 707 citations in OpenAlex.

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277 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 1 institution in 2 countries.

Alexander MelamedFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Daniel J MargulFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).ORCID 0000-0002-0907-1839
Ling ChenFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Nancy L KeatingFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Marcela G Del CarmenFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Junhua YangFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Brandon-Luke L SeagleFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Amy AlexanderFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Emma L BarberFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Laurel W RiceFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Jason D WrightFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Masha KocherginskyFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Shohreh ShahabiFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
J Alejandro Rauh-HainFrom the Division of Gynecologic Oncology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School (A.M., M.G.C.), and the Department of Health Care Policy, Harvard Medical School, and the Division of General Internal Medicine, Brigham and Women's Hospital (N.L.K.) - all in Boston; the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Prentice Women's Hospital (D.J.M., J.Y., B.-L.L.S., A.A., E.L.B., M.K., S.S.), and the Division of Biostatistics, Department of Preventive Medicine (M.K.), Northwestern University, Feinberg School of Medicine, Chicago; the Department of Obstetrics and Gynecology and Herbert Irving Comprehensive Cancer Center, Columbia University, and New York Presbyterian Hospital, New York (L.C., J.D.W.); the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison (L.W.R.); and the Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston (J.A.R.-H.).
Brigham and Women's Hospital · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
Tumor Environment and Metastasis (TEAM) Research ProgramP30CA060553 · NCI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Daniela E Matei · 1993 to 2026
$153.9M
Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
Program in Cancer Research Outcomes Training (PCORT)R25CA092203 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI GAZELLE, G SCOTT · 2002 to 2016
$8.2M
Research Career Development in Obstetrics and GynecologyK12HD050121 · NICHD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Serdar E. Bulun · 2005 to 2026
$7.2M
Training in Oncology Population Sciences (TOPS)T32CA092203 · NCI · DANA-FARBER CANCER INST · PI Nancy L Keating, JENNIFER W MACK · 2018 to 2026
$3.7M
Obstetrical and Oncological Outcomes Among Reproductive Age Women with Gynecological and Breast CancerK08CA234333 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI RAUH-HAIN, JOSE ALEJANDRO · 2018 to 2022
$1.2M
NCATS NIH HHS UL1 TR001422NCI NIH HHS K08 CA234333NCI NIH HHS P30 CA016672NCI NIH HHS P30 CA060553NCI NIH HHS R25 CA092203NCI NIH HHS T32 CA092203NICHD NIH HHS K12 HD050121
6 · The paper itself

Abstract

backgroundMinimally invasive surgery was adopted as an alternative to laparotomy (open surgery) for radical hysterectomy in patients with early-stage cervical cancer before high-quality evidence regarding its effect on survival was available. We sought to determine the effect of minimally invasive surgery on all-cause mortality among women undergoing radical hysterectomy for cervical cancer.

methodsWe performed a cohort study involving women who underwent radical hysterectomy for stage IA2 or IB1 cervical cancer during the 2010-2013 period at Commission on Cancer-accredited hospitals in the United States. The study used inverse probability of treatment propensity-score weighting. We also conducted an interrupted time-series analysis involving women who underwent radical hysterectomy for cervical cancer during the 2000-2010 period, using the Surveillance, Epidemiology, and End Results program database.

resultsIn the primary analysis, 1225 of 2461 women (49.8%) underwent minimally invasive surgery. Women treated with minimally invasive surgery were more often white, privately insured, and from ZIP Codes with higher socioeconomic status, had smaller, lower-grade tumors, and were more likely to have received a diagnosis later in the study period than women who underwent open surgery. Over a median follow-up of 45 months, the 4-year mortality was 9.1% among women who underwent minimally invasive surgery and 5.3% among those who underwent open surgery (hazard ratio, 1.65; 95% confidence interval [CI], 1.22 to 2.22; P=0.002 by the log-rank test). Before the adoption of minimally invasive radical hysterectomy (i.e., in the 2000-2006 period), the 4-year relative survival rate among women who underwent radical hysterectomy for cervical cancer remained stable (annual percentage change, 0.3%; 95% CI, -0.1 to 0.6). The adoption of minimally invasive surgery coincided with a decline in the 4-year relative survival rate of 0.8% (95% CI, 0.3 to 1.4) per year after 2006 (P=0.01 for change of trend).

conclusionsIn an epidemiologic study, minimally invasive radical hysterectomy was associated with shorter overall survival than open surgery among women with stage IA2 or IB1 cervical carcinoma. (Funded by the National Cancer Institute and others.).

Indexed as

Minimally Invasive Surgical ProceduresAdenocarcinomaAdultCarcinoma, AdenosquamousCarcinoma, Squamous CellCause of DeathChi-Square DistributionCohort StudiesFemaleHumansHysterectomyMiddle AgedNeoplasm Recurrence, LocalNeoplasm StagingPropensity ScoreSEER Program

Identifiers

PMID30379613
PMCPMC6464372
OpenAlexW2898811719

What OpenQuestion holds

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Read underepoch 390

Registered trials

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.