Abstract B20: Uptake and safety of bilateral salpingectomy for ovarian cancer prevention in the United States.
Notice bibliographique
Résumé
Abstract Ovarian cancer is the leading cause of death due to gynecologic malignancy and the fifth most common cause of cancer deaths in developed countries. Recent evidence has indicated that the most common and lethal form of ovarian cancer originates in the distal fallopian tube, making surgical removal of the fallopian tube (bilateral salpingectomy) at the time of other gynecologic surgeries (particularly hysterectomy and tubal ligation) a potential ovarian cancer prevention strategy. We aimed to assess the uptake and perioperative safety of bilateral salpingectomy (BS) as an ovarian cancer risk-reduction strategy in the United States and to examine the factors associated with increased likelihood of getting a BS with benign gynecologic surgery. The Nationwide Inpatient Sample was used to identify all women 15 years or older who underwent inpatient hysterectomy or tubal sterilization between 2008 and 2012. Weighted estimates of national trends were calculated and the number of procedures performed estimated. Safety was assessed by examining rates of blood transfusions, perioperative complications, post procedural infection and fever, and adjusted odds ratios were calculated comparing hysterectomy with salpingectomy with hysterectomy alone. There was an increase in the uptake of hysterectomy with BS of 129% across the study period; however, this represented only 1.9% of total hysterectomies. There were only 233 salpingectomies for sterilization, thus no further comparisons were possible in this group. In the hysterectomy with BS women, there was no statistically significantly increased risk for blood transfusion (aOR, 0.89; 95%CI 0.79, 1.00) post-operative complications (aOR, 0.94; 95%CI 0.83, 1.07), post-operative infections (aOR, 1.44; 95%CI 0.97, 2.14) or fevers (aOR, 1.33; 1.00, 1.77) compared with women undergoing hysterectomy alone. Being younger, having more chronic conditions, being in a private, for profit hospital, indication for hysterectomy, and not being operated on in a small hospital were all associated with increased likelihood of getting a hysterectomy with BS compared to getting a hysterectomy alone. Our results suggest that, despite some significant growth, relatively few patients were receiving BS in the United States between 2008 and 2012. Given that the Society for Gynecologic Oncology and the American College of Obstetrics and Gynecology published recommendations to discuss BS with patients undergoing hysterectomy or tubal ligation in 2013 and 2015 respectively, and that our data extends only to 2012 we expect that rates may have risen more dramatically following those recommendations. Despite not reaching statistical significance, the aORs for both post-operative infection and fever were suggestive of an increased risk in women undergoing hysterectomy with BS. We hypothesize this is related to indication for BS,including hydrosalpinx and pelvic inflammatory disease, but recommend further research. Citation Format: Gillian Hanley, Jessica McAlpine, Leigh Pearce. Uptake and safety of bilateral salpingectomy for ovarian cancer prevention in the United States. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: Exploiting Vulnerabilities; Oct 17-20, 2015; Orlando, FL. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(2 Suppl):Abstract nr B20.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».