Evidence map›Paper›PMID 31375270›Full record

ArticleGynecologic oncology2019

Risk of cervical and vaginal dysplasia after surgery for vulvar intraepithelial neoplasia or cancer: A 6 year follow-up study.

Tommy R Buchanan, Abigail S Zamorano, Leslie S Massad, Jingxia Liu, Premal H Thaker, Matthew A Powell, David G Mutch, Lindsay M Kuroki

Open access · greenAbstract read
In one paragraph

Article in Gynecologic oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. European Society of Gynaecological Oncology Guidelines for the Management of Patients with Vulvar Cancer - Update 2023.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2023
    Guideline
  2. Article
  3. Article
  4. Vulval premalignant lesions: a review article.Obstetrics & gynecology science · 2024
    Article
  5. Comprehensive management of vulvovaginal cancers.CA: a cancer journal for clinicians
    Review
  6. Review
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

8 authors at 2 institutions in 1 country.

Tommy R BuchananDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA; Alvin J. Siteman Cancer Center, St Louis, MO, USA. Electronic address: tbuchanan@wustl.edu.
Abigail S ZamoranoDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA; Alvin J. Siteman Cancer Center, St Louis, MO, USA.
Leslie S MassadDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA; Alvin J. Siteman Cancer Center, St Louis, MO, USA.
Jingxia LiuDivision of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Premal H ThakerDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA; Alvin J. Siteman Cancer Center, St Louis, MO, USA.
Matthew A PowellDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA; Alvin J. Siteman Cancer Center, St Louis, MO, USA.
David G MutchDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA; Alvin J. Siteman Cancer Center, St Louis, MO, USA.
Lindsay M KurokiDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA; Alvin J. Siteman Cancer Center, St Louis, MO, USA.
Alvin J. Siteman Cancer CenterWashington University in St. Louis · US

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
Washington University Institute of Clinical and Translational SciencesUL1TR000448 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$41.4M
Postdoctoral Training in Cancer Prevention and ControlT32CA190194 · NCI · WASHINGTON UNIVERSITY · PI GRAHAM A. COLDITZ, AIMEE S JAMES · 2014 to 2026
$4.7M
Washington University Cancer Genomics and Outcomes Research STRENGTH ProgramR25CA190190 · NCI · WASHINGTON UNIVERSITY · PI GOVINDAN, RAMASWAMY · 2015 to 2019
$1.0M
NCATS NIH HHS UL1 TR000448NCATS NIH HHS UL1 TR002345NCI NIH HHS R25 CA190190NCI NIH HHS T32 CA190194
6 · The paper itself

Abstract

objectivesTo estimate the frequency of abnormal surveillance cytology leading to high-grade dysplasia after surgical management for high-grade vulvar intraepithelial neoplasia (VIN) and vulvar cancer and to determine whether prior hysterectomy reduces this risk.

methodsWomen who underwent surgery for high-grade VIN or vulvar cancer between 2006 and 2014 were identified retrospectively. Patients who underwent prior hysterectomy for any indication were included. Univariate and multivariate logistic regression analyses were used to identify clinical correlates of abnormal cytology after surgical treatment for VIN and vulvar cancer.

resultsDuring a median follow-up for 72 months, 302 women underwent surveillance with cytologic screening after vulvar surgery including 99 (33%) women with prior hysterectomy. 75 (25%) women had abnormal cytology results. Of those, 47 (63%) were low-grade and 28 (37%) were high-grade, including 2 (3%) cases of invasive cancer. The rates of high-grade vaginal intraepithelial neoplasia (VAIN), cervical intraepithelial neoplasia (CIN), or cancer were not significantly different despite prior hysterectomy (9% VAIN 2+, 7% CIN 2+). Multivariate analysis showed that correlates of high-grade cytology following treatment for VIN or vulvar cancer included non-white race [odds radio (OR) 3.6, 95% confidence interval (CI) 1.7-7.8], prior abnormal cytology (OR 3.5, 95% CI 1.6-7.6), and immunodeficiency (OR 3.4, 95% CI 1.3-8.8). Prior hysterectomy did not significantly decrease risk of high-grade cytology (OR 0.87, 95% CI 0.5-1.6).

conclusionsWomen treated surgically for VIN/vulvar cancer have an 8% risk of at least high-grade dysplasia from surveillance screening and prior hysterectomy does not mitigate the risk. Extrapolating from current guidelines, we recommend surveillance cytology screening at least 6-12 months after treatment.

Indexed as

Carcinoma in SituFemaleFollow-Up StudiesHumansMiddle AgedNeoplasm GradingPrecancerous ConditionsRetrospective StudiesUterine Cervical DysplasiaVaginal DiseasesVulvar NeoplasmsWashingtonCervical cancerCervical dysplasiaPreventionScreeningVulvar cancerVulvar dysplasia

Identifiers

PMID31375270
PMCPMC7757628
OpenAlexW2948021049

What OpenQuestion holds

Textmetadata
LicenceTDM
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.