Evidence map›Paper›PMID 34187504›Full record

ArticleRadiation oncology (London, England)2021

Adjuvant hysterectomy following primary chemoradiation for stage IB2 and IIA2 cervical cancer: a retrospective comparison of complications for open versus minimally invasive surgery.

Heather Miller, Koji Matsuo, Lynda D Roman, Annie A Yessaian, Huyen Q Pham, Marianne Hom, Antonio Castaneda, Anthony Pham, Omar Ragab, Laila Muderspach and 2 more

Erratum issuedOpen access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Radiation oncology (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 40% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Heather MillerDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA.
Koji MatsuoDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA.
Lynda D RomanDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA.
Annie A YessaianDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA.
Huyen Q PhamDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA.
Marianne HomDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA.
Antonio CastanedaDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA.
Anthony PhamDepartment of Radiation Oncology, University of Southern California, Los Angeles, CA, 90033, USA.
Omar RagabDepartment of Radiation Oncology, University of Southern California, Los Angeles, CA, 90033, USA.
Laila MuderspachDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA.
Marcia CicconeDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA.
Laurie L BrunetteDivision of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave, IRD 526, Los Angeles, CA, 90033, USA. laurie.brunette@med.usc.edu.ORCID http://orcid.org/0000-0003-1049-764X
University of Southern California · US

Funding

Ensign Endowment for Gynecologic Cancer Research Ensign Endowment for Gynecologic Cancer Research
6 · The paper itself

Abstract

backgroundAdjuvant hysterectomy following chemoradiation for bulky, early stage cervical cancer has been shown to decrease local relapse rate. The objective of this study is to compare complications and recurrences between minimally invasive and open adjuvant hysterectomy for early stage cervical cancer.

methodsPatients were identified who had undergone adjuvant hysterectomy following chemoradiation for 2009 FIGO stage IB2 and IIA2 cervical cancer from August 2006 to June 2018. Demographic information, treatment course, complications, recurrence data were retrospectively extracted from the medical record. Frequency of complications was compared with Fisher exact test or chi-square test as appropriate and inverse probability of treatment propensity score weighting was used to calculate the disease-free survival.

resultsFifty-four patients met inclusion criteria with a median follow up time of 60.4 months (interquartile range 28.0-98.1 months). There were 24 (44%) open versus 30 (56%) minimally invasive hysterectomies performed. The overall grade 2 or worse complication rate was 43%. There were 8 (27%) patients with complications in the minimally invasive group compared to 4 (17%) in the open group (OR 1.82 (95% CI 0.5-7.0)). There were 9 vaginal cuff defects, dehiscences and/or fistulas in the minimally invasive group compared to 3 in the open group (OR 3.0 (95% CI 0.8-11.2)). There was no statistically significant difference between disease free survival and overall survival among the two groups, however there was a trend towards decreased disease-free survival in the minimally invasive group.

conclusionsAmong women undergoing adjuvant hysterectomy following chemoradiation for bulky, early stage cervical cancer, there was no difference in complication rates between an open or minimally invasive surgical approach. However, the overall complication rate was high, including a high rate of vaginal cuff defect, dehiscence and/or fistulas. Our findings suggest that an adjuvant hysterectomy should be reserved for patients in which chemoradiation is not anticipated to successfully treat the primary tumor and, if performed, an open approach should be considered.

Indexed as

ChemoradiotherapyAbdomenAdenocarcinomaAdultCarcinoma, AdenosquamousCarcinoma, Squamous CellCombined Modality TherapyFemaleHumansHysterectomyMiddle AgedMinimally Invasive Surgical ProceduresNeoadjuvant TherapyNeoplasm StagingRetrospective StudiesTreatment OutcomeAdjuvant hysterectomyCervical cancerChemoradiationComplicationFistulaHysterectomyVaginal cuff

Identifiers

PMID34187504
PMCPMC8244186
OpenAlexW2954473407

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.