Evidence map›Paper›PMID 31978437›Full record

ArticleAmerican journal of obstetrics and gynecology2020

Progestin therapy for obese women with complex atypical hyperplasia: levonorgestrel-releasing intrauterine device vs systemic therapy.

Rachel S Mandelbaum, Marcia A Ciccone, David J Nusbaum, Mahdi Khoshchehreh, Heena Purswani, Elise B Morocco, Meghan B Smith, Shinya Matsuzaki, Christina E Dancz, Begum Ozel and 3 more

Registry-linked trialOpen access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of obstetrics and gynecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05619159 (the Value of Immunohistochemical Expression of Moesin in Endometrial Hyperplasia and Endometrial Carcinoma), which is not on this map. Cited by 19 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 5 pooled it
6.0field-weighted citation impact, top 4% 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.

NCT05619159 unknown statusnot on this mapstarted 2022, after this paper: background citation

the Value of Immunohistochemical Expression of Moesin in Endometrial Hyperplasia and Endometrial Carcinoma

TypeobservationalSponsorSohag UniversityRan2022 to 2023Enrolled100ConditionsEndometrial Cancer and Endometrial HyperplasiaArmsmicroscopic pathological evaluation
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 5 syntheses or guidelines pooled it, 46 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Endometrial hyperplasia as a risk factor of endometrial cancer.Archives of gynecology and obstetrics · 2022
    Pooled it
  5. Pooled it
  6. Trial
  7. Review
  8. Review
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. An Update on Contraception in Polycystic Ovary Syndrome.Endocrinology and metabolism (Seoul, Korea) · 2021
    Article
  17. Route-specific association of progestin therapy and concurrent metformin use in obese women with complex atypical hyperplasia.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2020
    Article
  18. Observational
  19. 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

13 authors at 1 institution in 1 country.

Rachel S MandelbaumDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Marcia A CicconeDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California.
David J NusbaumDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Mahdi KhoshchehrehDepartment of Pathology, University of Southern California, Los Angeles, California.
Heena PurswaniDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Elise B MoroccoDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Meghan B SmithDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Shinya MatsuzakiDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Christina E DanczDivision of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Begum OzelDivision of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Lynda D RomanDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California.
Richard J PaulsonDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Koji MatsuoDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California. Electronic address: koji.matsuo@med.usc.edu.
University of Southern California · US

Funding

USC/NORRIS COMPREHENSIVE CANCER CENTER (CORE) SUPPORTP30CA014089 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Fumito Ito · 1985 to 2026
$181.4M
NCI NIH HHS P30 CA014089
6 · The paper itself

Abstract

backgroundThough hysterectomy remains the standard treatment for complex atypical hyperplasia, patients who desire fertility or who are poor surgical candidates may opt for progestin therapy. However, the effectiveness of the levonorgestrel-releasing intrauterine device compared to systemic therapy in the treatment of complex atypical hyperplasia has not been well studied.

objectiveWe sought to examine differences in treatment response between local progestin therapy with the levonorgestrel-releasing intrauterine device and systemic progestin therapy in women with complex atypical hyperplasia.

methodsThis single-institution retrospective study examined women with complex atypical hyperplasia who received progestin therapy between 2003 and 2018. Treatment response was assessed by histopathology on subsequent biopsies. Time-dependent analyses of complete response and progression to cancer were performed comparing the levonorgestrel-releasing intrauterine device and systemic therapy. A propensity score inverse probability of treatment weighting model was used to create a weighted cohort that differed based on treatment type but was similar with respect to other characteristics. An interaction-term analysis was performed to examine the impact of body habitus on treatment response, and an interrupted time-series analysis was employed to assess if changes in treatment patterns correlated with outcomes over time.

resultsA total of 245 women with complex atypical hyperplasia received progestin therapy (levonorgestrel-releasing intrauterine device n = 69 and systemic therapy n = 176). The mean age and body mass index were 36.9 years and 40.0 kg/m

conclusionOur study suggests that local therapy with the levonorgestrel-releasing intrauterine device may be more effective than systemic therapy for women with complex atypical hyperplasia who opt for nonsurgical treatment, particularly in morbidly obese women. Shifts in treatment paradigm during the study period toward increased levonorgestrel-releasing intrauterine device use also led to improved complete response rates despite increasing rates of obesity.

Indexed as

Intrauterine Devices, MedicatedAdultEndometrial HyperplasiaFemaleHumansLevonorgestrelObesity, MorbidProgestinsRetrospective StudiesTreatment OutcomeLevonorgestrelProgestinscomplete responsecomplex endometrial hyperplasialevonorgestrel-releasing intrauterine systemobesityprogestin therapy

Identifiers

PMID31978437
PMCPMC7751571
OpenAlexW3001001971

What OpenQuestion holds

Textmetadata
LicenceTDM
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.