Evidence map›Paper›PMID 31948730›Full record

ArticleGynecologic oncology2020

Adjuvant therapy for early stage, endometrial cancer with lymphovascular space invasion: Is there a role for chemotherapy?

Anna L Beavis, Ting-Tai Yen, Rebecca L Stone, Stephanie L Wethington, Caitlin Carr, Ji Son, Laura Chambers, Chad M Michener, Stephanie Ricci, Wesley C Burkett and 19 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Gynecologic oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 15% 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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

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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

29 authors at 8 institutions in 1 country.

Anna L BeavisThe Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: abeavis2@jhmi.edu.
Ting-Tai YenThe Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Rebecca L StoneThe Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Stephanie L WethingtonThe Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Caitlin CarrDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA.
Ji SonDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA.
Laura ChambersDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA.
Chad M MichenerDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA.
Stephanie RicciDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA.
Wesley C BurkettDepartment of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Debra L RichardsonStephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Allison-Stuart StaleyDepartment of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
Susie AhnDepartment of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
Paola A GehrigDepartment of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
Diogo TorresDepartment of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.
Sean C DowdyDepartment of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.
Mackenzie W SullivanDepartment of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, USA.
Susan C ModesittDepartment of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, USA.
Catherine WatsonDepartment of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
Ashely VeadeDepartment of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
Jessie EhrismanDepartment of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
Laura HavrileskyDepartment of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
Angeles Alvarez SecordDepartment of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
Amy LoreenDepartment of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Kaitlyn GriffinDepartment of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Amanda JacksonDepartment of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Akila N ViswanathanDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Leah R JagerDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Amanda N FaderThe Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Johns Hopkins University · USCleveland Clinic · USDuke Medical Center · USUniversity of Cincinnati · USUniversity of North Carolina at Chapel Hill · USMayo Clinic in Arizona · USUniversity of Oklahoma Health Sciences Center · USUniversity of Virginia · US

Funding

Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
QAQC Johns Hopkins Institute for Clinical and Translational ResearchUL1TR003098 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2019 to 2023
$57.7M
The Johns Hopkins Clinical Research Scholars in Women's Health (BIRCWH)K12HD085845 · NICHD · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2015 to 2023
$4.5M
NCATS NIH HHS UL1 TR001079NCATS NIH HHS UL1 TR003098NICHD NIH HHS K12 HD085845
6 · The paper itself

Abstract

objectivesLymphovascular space invasion (LVSI) is an independent risk factor for recurrence and poor survival in early-stage endometrioid endometrial cancer (EEC), but optimal adjuvant treatment is unknown. We aimed to compare the survival of women with early-stage EEC with LVSI treated postoperatively with observation (OBS), radiation (RAD, external beam and/or vaginal brachytherapy), or chemotherapy (CHEMO)+/-RAD.

methodsThis was a multi-institutional, retrospective cohort study of women with stage I or II EEC with LVSI who underwent hysterectomy+/-lymphadenectomy from 2005 to 2015 and received OBS, RAD, or CHEMO+/-RAD postoperatively. Progression-free survival and overall survival were evaluated using Kaplan-Meier estimates and Cox proportional hazards models.

resultsIn total, 478 women were included; median age was 64 years, median follow-up was 50.3 months. After surgery, 143 (30%) underwent OBS, 232 (48.5%) received RAD, and 103(21.5%) received CHEMO+/-RAD (95% of whom received RAD). Demographics were similar among groups, but those undergoing OBS had lower stage and grade. A total of 101 (21%) women recurred. Progression-free survival (PFS) was improved in both CHEMO+/-RAD (HR = 0.18, 95% CI: 0.09-0.39) and RAD (HR = 0.31, 95% CI: 0.18-0.54) groups compared to OBS, though neither adjuvant therapy was superior to the other. However, in grade 3 tumors, the CHEMO+/-RAD group had superior PFS compared to both RAD (HR 0.25; 95% CI: 0.12-0.52) and OBS cohorts (HR = 0.10, 95% CI: 0.03-0.32). Overall survival did not differ by treatment.

conclusionsIn early-stage EEC with LVSI, adjuvant therapy improved PFS compared to observation alone. In those with grade 3 EEC, adjuvant chemotherapy with or without radiation improved PFS compared to observation or radiation alone.

Indexed as

AdultAgedAged, 80 and overCarcinoma, EndometrioidChemoradiotherapy, AdjuvantChemotherapy, AdjuvantCohort StudiesDisease-Free SurvivalEndometrial NeoplasmsFemaleHumansHysterectomyLymphatic MetastasisLymph Node ExcisionMiddle AgedNeoplasm GradingAdjuvant treatmentChemotherapyEndometrial cancerLymphovascular space invasionRadiationUterine cancer

Identifiers

PMID31948730
PMCPMC7388269
OpenAlexW2999955775

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.