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10.1016/j.ygyno.2020.05.019

http://scihub22266oqcxt.onion/10.1016/j.ygyno.2020.05.019
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suck abstract from ncbi


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pmid32425268      Gynecol+Oncol 2020 ; 158 (1): 37-43
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  • Wait-time for hysterectomy and survival of women with early-stage cervical cancer: A clinical implication during the coronavirus pandemic #MMPMID32425268
  • Matsuo K; Novatt H; Matsuzaki S; Hom MS; Castaneda AV; Licon E; Nusbaum DJ; Roman LD
  • Gynecol Oncol 2020[Jul]; 158 (1): 37-43 PMID32425268show ga
  • OBJECTIVE: A global pandemic caused by a novel coronavirus (Covid-19) has created unique challenges to providing timely care for cancer patients. In early-stage cervical cancer, postponing hysterectomy for 6-8 weeks is suggested as a possible option in the Covid-19 burdened hospitals. Yet, literature examining the impact of surgery wait-time on survival in early-stage cervical cancer remains scarce. This study examined the association between surgery wait-time of 8 weeks and oncologic outcome in women with early-stage cervical cancer. METHODS: This is a single institution retrospective observational study at a tertiary referral medical center examining women who underwent primary hysterectomy or trachelectomy for clinical stage IA-IIA invasive cervical cancer between 2000 and 2017 (N = 217). Wait-time from the diagnosis of invasive cervical cancer via biopsy to definitive surgery was categorized as: short wait-time (<8 weeks; n = 110) versus long wait-time (>/=8 weeks; n = 107). Propensity score inverse probability of treatment weighting was used to balance the measured demographics between the two groups, and disease-free survival (DFS) and overall survival (OS) were assessed. A systematic literature review with meta-analysis was additionally performed. RESULTS: In a weighted model (median follow-up, 4.6 years), women in the long wait-time group had DFS (4.5-year rates, 91.2% versus 90.7%, hazard ratio [HR] 1.11, 95% confidence interval [CI] 0.47-2.59, P = 0.818) and OS (95.0% versus 97.4%, HR 1.47, 95%CI 0.50-4.31, P = 0.487) similar to those in the short wait-time group. Three studies were examined for meta-analysis, and a pooled HR for surgery wait-time of >/=8 weeks on DFS was 0.96 (95%CI 0.59-1.55). CONCLUSION: Our study suggests that wait-time of 8 weeks for hysterectomy may not be associated with short-term disease recurrence in women with early-stage cervical cancer.
  • |Adult[MESH]
  • |Aged[MESH]
  • |Betacoronavirus/isolation & purification[MESH]
  • |COVID-19[MESH]
  • |California/epidemiology[MESH]
  • |Coronavirus Infections/*epidemiology[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Hysterectomy/methods/*statistics & numerical data[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*epidemiology[MESH]
  • |Propensity Score[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]
  • |Tertiary Care Centers/statistics & numerical data[MESH]
  • |Time-to-Treatment/*statistics & numerical data[MESH]


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