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Variation in Outcome Reporting Identified in Studies of Fertility-Sparing Surgery for Cervical Cancer: a Systematic Review
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  • Nathanael Yong,
  • Natalie Cooper,
  • Sarah Yorke,
  • Chawan Baran,
  • Khalid Khan,
  • Alex Tan,
  • Michail Sideris,
  • Stamatina Iliodromiti,
  • Ranjit Manchanda
Nathanael Yong
Royal Surrey County Hospital NHS Foundation Trust
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Natalie Cooper
Barts and The London School of Medicine and Dentistry Blizard Institute
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Sarah Yorke
Queen Mary University Institute of Population Health Sciences
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Chawan Baran
Barts Health NHS Trust
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Khalid Khan
University of Granada
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Alex Tan
Royal Surrey NHS Foundation Trust
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Michail Sideris
Queen Mary University of London
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Stamatina Iliodromiti
QMUL
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Ranjit Manchanda
Wolfson Institute of Population Health, Queen Mary University of London
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Abstract

Background: Cervical cancer affects 3,197 women in the UK, and 604000 women worldwide annually, with peak incidence seen between 30-34 years of age. For many, fertility-sparing surgery is an appealing option where possible. However, absence of large-scale data, along with a notable variation in reported outcomes in relevant studies may undermine future efforts for consistent evidence synthesis. Objectives: To systematically review the reported outcomes measured in studies that include women who underwent fertility-sparing surgery for cervical cancer and identify whether variation exists. Search Strategy: We searched MEDLINE, EMBASE, and CENTRAL from inception to February 2019. Selection Criteria: Randomised controlled trials, cohort and observational studies, and case studies of more than 10 participants from January 1990 to date. Data Collection and Analysis: Study characteristics and all reported treatment outcomes. Main results: 104 studies with a sum of 9535 participants were identified. Most studies reported on oncological outcomes (97/104), followed by fertility and pregnancy (86/104), post-operative complications (74/104), intra-operative complications (72/104), and quality of life (5). There were huge variation and heterogeneity in reported outcomes, with only 12% being good quality and 87% being of poor quality. Conclusions: There is significant heterogeneity in the reported outcomes. An agreed Core Outcome Set (COS) is necessary for future studies to effectively harmonise reported outcomes that are measurable and relevant to patients, clinicians, and researchers. This systematic review sets the groundwork for the development of a COS for fertility sparing surgery in cervical cancer. Funding: British Medical Association’s Strutt and Harper Grant.
07 Aug 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
13 Aug 2022Assigned to Editor
13 Aug 2022Submission Checks Completed
16 Aug 2022Reviewer(s) Assigned
18 Sep 2022Review(s) Completed, Editorial Evaluation Pending
28 Sep 2022Editorial Decision: Revise Minor