Evidence map›Paper›PMID 39446231›Full record

ArticleAnnals of surgical oncology2025

Management of the Uninvolved Uterus and Adnexa During Routine Pelvic Peritonectomy in Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Varies by Histology and Menopausal Status: An International Survey of Peritoneal Surface Malignancy Surgeons.

Nolan M Winicki, Shannon N Radomski, Isabella S Florissi, Stephanie Wethington, Ignace de Hingh, Laurent Villeneuve, Olivier Glehen, Jesus Esquivel, Aditi Bhatt, Fabian M Johnston and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
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

11 authors.

Nolan M WinickiDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Shannon N RadomskiDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Isabella S FlorissiDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Stephanie WethingtonDepartment of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ignace de HinghDepartment of Surgery, Catharina Cancer Institute, Eindhoven, The Netherlands.
Laurent VilleneuveClinical Research and Epidemiological Unit, Department of Public Health, Lyon University Hospital, University of Lyon, Lyon, EA, France.
Olivier GlehenDepartment of Digestive Surgery, Lyon University Hospital, University of Lyon, Lyon, EA, France.
Jesus EsquivelDepartment of Surgical Oncology, Beebe Healthcare, Lewes, DE, USA.
Aditi BhattDepartment of Surgical Oncology, KD Hospital, Ahmedabad, India.
Fabian M JohnstonDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jonathan B GreerDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. jgreer13@jhmi.edu.ORCID http://orcid.org/0000-0001-8968-9710

Funding

Clinical and Laboratory Research Training for Surgical OncologistsT32CA126607 · NCI · JOHNS HOPKINS UNIVERSITY · PI CAMERON, ANDREW M. · 2008 to 2024
$6.0M
NCI NIH HHS 5T32CA126607-12
6 · The paper itself

Abstract

backgroundNo guidelines exist regarding the management of the uninvolved uterus or adnexa (fallopian tubes and/or ovaries) in patients with peritoneal metastases (PM) from non-gynecologic malignancies. It is unclear whether salpingo-oophorectomy, hysterectomy, or both should be performed when a complete pelvic peritonectomy is otherwise warranted.

methodsA 25-item electronic survey was sent to 225 surgeons worldwide who routinely perform cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC). Participants were recruited through listservs of expert groups. Individual surgeon approaches to the management of the grossly uninvolved uterus and adnexa in pre- and post-menopausal women with PM from low- and high-grade appendiceal neoplasms, colorectal cancer, and peritoneal mesothelioma were collected using a 5-point Likert scale.

resultsA total of 135 complete responses (60% response rate) were obtained from surgeons practicing in 27 countries. Respondents reported a median practice of 10 years (interquartile range [IQR] 6-15 years) and a median performance of 20 (IQR 12-30) CRS/HIPEC operations per year. Rates of salpingo-oophorectomy differed by histology and a woman's menopausal status, ranging from 29 to 42% in pre-menopausal women to 71-77% in post-menopausal women (P < 0.001). Notably, the number of surgeons who would perform a hysterectomy was lower, ranging from 12 to 27% for pre-menopausal women and from 32 to 44% for post-menopausal women, dependent on histology (P < 0.001).

conclusionsSurgeons are overall more aggressive with adnexal resection than with hysterectomy in both pre- and post-menopausal women with PM from non-gynecologic malignancies. Further prospective studies are required to determine the best approach to optimize surgical and oncologic outcomes while also accounting for the fertility and hormonal impact.

Indexed as

Appendiceal NeoplasmsCytoreduction Surgical ProceduresHyperthermic Intraperitoneal ChemotherapyPeritoneal NeoplasmsAdnexa UteriColorectal NeoplasmsCombined Modality TherapyFemaleFollow-Up StudiesHumansHysterectomyMenopauseMesotheliomaMiddle AgedPractice Patterns, Physicians'PrognosisAdnexaCRS/HIPECHysterectomyNon-gynecological malignancySalpingo-oophorectomyUterus,

Identifiers

PMID39446231

What OpenQuestion holds

Textmetadata
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.