Evidence map›Paper›PMID 34265441›Full record

ArticleJournal of minimally invasive gynecology2022

Endometrial Sampling for Preoperative Diagnosis of Uterine Leiomyosarcoma.

Rosanne M Kho, Vrunda B Desai, Peter E Schwartz, Jason D Wright, Cary P Gross, Lindsey M Hutchison, Francis P Boscoe, Haiqun Lin, Xiao Xu

Abstract read
In one paragraph

Article in Journal of minimally invasive gynecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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

7 citing papers in PubMed.

  1. Article
  2. Review
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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

9 authors.

Rosanne M KhoDepartment of Obstetrics and Gynecology, Women's Health Institute, Cleveland Clinic, Cleveland, Ohio (Dr. Kho).
Vrunda B DesaiDepartment of Obstetrics, Gynecology & Reproductive Sciences (Drs. Desai, Schwartz, and Xu); CooperSurgical Inc., Trumbull (Dr. Desai), Connecticut.
Peter E SchwartzDepartment of Obstetrics, Gynecology & Reproductive Sciences (Drs. Desai, Schwartz, and Xu).
Jason D WrightDepartment of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York (Dr. Wright).
Cary P GrossDepartment of Internal Medicine (Dr. Gross); Yale Cancer Outcomes, Public Policy and Effectiveness Research Center (Drs. Gross and Xu), Yale School of Medicine, New Haven.
Lindsey M HutchisonNew York State Cancer Registry, New York State Department of Health, Albany (Dr. Boscoe and Ms. Hutchison), New York.
Francis P BoscoeNew York State Cancer Registry, New York State Department of Health, Albany (Dr. Boscoe and Ms. Hutchison), New York.
Haiqun LinDivision of Nursing Science, Rutgers University School of Nursing (Dr. Lin); Department of Biostatistics and Epidemiology, Rutgers School of Public Health (Dr. Lin), Newark, New Jersey.
Xiao XuDepartment of Obstetrics, Gynecology & Reproductive Sciences (Drs. Desai, Schwartz, and Xu); Yale Cancer Outcomes, Public Policy and Effectiveness Research Center (Drs. Gross and Xu), Yale School of Medicine, New Haven. Electronic address: xiao.xu@yale.edu.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Occult Uterine Cancer and Power Morcellation in Hysterectomy and MyomectomyR01HS024702 · AHRQ · YALE UNIVERSITY · PI XU, XIAO · 2016 to 2018
$1.0M
AHRQ HHS R01 HS024702NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

STUDY

objectivesTo examine the effectiveness of endometrial sampling for preoperative detection of uterine leiomyosarcoma in women undergoing hysterectomy, identify factors associated with missed diagnosis, and compare the outcomes of patients who had a preoperative diagnosis with those of patients who had a missed diagnosis.

designRetrospective cohort study using linked data from the New York Statewide Planning and Research Cooperative System and New York State Cancer Registry from 2003 to 2015.

settingInpatient and outpatient encounters at civilian hospitals and ambulatory surgery centers in New York State. PATIENTS: Women with uterine leiomyosarcoma who underwent a hysterectomy and a preoperative endometrial sampling within 90 days before the hysterectomy.

interventionsEndometrial sampling. MEASUREMENTS AND MAIN

resultsA total of 79 patients with uterine leiomyosarcoma met the sample eligibility criteria. Of these patients, 46 (58.2%) were diagnosed preoperatively, and 33 (41.8%) were diagnosed postoperatively. Patients in the 2 groups did not differ significantly in age, race/ethnicity, bleeding symptoms, or comorbidities assessed. In multivariable regression analysis, women who had endometrial sampling performed with hysteroscopy (compared with women who had endeometrial sampling performed without hysteroscopy) had a higher likelihood of preoperative diagnosis (adjusted risk ratio [aRR] 3.03; 95% confidence interval [CI], 1.43-6.42). Patients with localized stage (vs distant stage) or tumor size >11 cm (vs <8 cm) were less likely to be diagnosed preoperatively (aRR 0.50; 95% CI, 0.28-0.89, and aRR 0.54; 95% CI, 0.30-0.99, respectively). Supracervical hysterectomy was not performed in any of the patients whose leiomyosarcoma was diagnosed preoperatively compared with 21.2% of the patients who were diagnosed postoperatively (p = .002).

conclusionEndometrial sampling detected leiomyosarcoma preoperatively in 58.2% of the patients. The use of hysteroscopy with endometrial sampling improved preoperative detection of leiomyosarcoma by threefold. Patients with a missed diagnosis had a higher risk of undergoing suboptimal surgical management at the time of their index surgery.

Indexed as

Endometrial NeoplasmsLeiomyosarcomaUterine NeoplasmsEndometriumFemaleHumansHysterectomyRetrospective StudiesEndometrial samplingHysterectomyHysteroscopyLeiomyosarcoma

Identifiers

PMID34265441
PMCPMC8752465

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Registered trials

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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.