JNCI J Natl Cancer Inst (2015) 107(11): djv251 doi:10.1093/jnci/djv251 First published online October 8, 2015 Article
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Jason D. Wright, Rosa R. Cui, Anqi Wang, Ling Chen, Ana I. Tergas, William M. Burke, Cande V. Ananth, June Y. Hou, Alfred I. Neugut, Sarah M. Temkin, Y. Claire Wang*, Dawn L. Hershman* Affiliations of authors: Department of Obstetrics and Gynecology (JDW, RRC, LC, AIT, WMB, CVA, JYH) and Department of Medicine (AIN, DLH), Columbia University College of Physicians and Surgeons; Department of Epidemiology (AIT, CVA, AIN, DLH) and Department of Health Policy and Management (AW, YCW), Mailman School of Public Health, Columbia University; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons (JDW, AIT, WMB, JYH, AIN, DLH); New York Presbyterian Hospital, New York, NY (JDW, AIT, WMB, JYH, AIN, DLH); National Cancer Institute, Bethesda, MD (SMT). *Authors contributed equally to this work. Correspondence to: Jason D. Wright, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Ave, 8th Floor, New York, NY 10032 (e-mail: [email protected]).
Abstract Background: Electric power morcellation during laparoscopic hysterectomy allows some women to undergo minimally invasive surgery but may disrupt underlying occult malignancies and increase the risk of tumor dissemination.
article
Methods: We developed a state transition Markov cohort simulation model of the risks and benefits of hysterectomy (abdominal, laparoscopic, and laparoscopic with electric power morcellation) for women with presumed benign gynecologic disease. The model considered perioperative morbidity, mortality, risk of cancer and dissemination, and outcomes in women with an underlying malignancy. We explored the effectiveness from a societal perspective stratified by age (
article
Jason D. Wright, Rosa R. Cui, Anqi Wang, Ling Chen, Ana I. Tergas, William M. Burke, Cande V. Ananth, June Y. Hou, Alfred I. Neugut, Sarah M. Temkin, Y. Claire Wang*, Dawn L. Hershman* Affiliations of authors: Department of Obstetrics and Gynecology (JDW, RRC, LC, AIT, WMB, CVA, JYH) and Department of Medicine (AIN, DLH), Columbia University College of Physicians and Surgeons; Department of Epidemiology (AIT, CVA, AIN, DLH) and Department of Health Policy and Management (AW, YCW), Mailman School of Public Health, Columbia University; Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons (JDW, AIT, WMB, JYH, AIN, DLH); New York Presbyterian Hospital, New York, NY (JDW, AIT, WMB, JYH, AIN, DLH); National Cancer Institute, Bethesda, MD (SMT). *Authors contributed equally to this work. Correspondence to: Jason D. Wright, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Ave, 8th Floor, New York, NY 10032 (e-mail: [email protected]).
Abstract Background: Electric power morcellation during laparoscopic hysterectomy allows some women to undergo minimally invasive surgery but may disrupt underlying occult malignancies and increase the risk of tumor dissemination.
article
Methods: We developed a state transition Markov cohort simulation model of the risks and benefits of hysterectomy (abdominal, laparoscopic, and laparoscopic with electric power morcellation) for women with presumed benign gynecologic disease. The model considered perioperative morbidity, mortality, risk of cancer and dissemination, and outcomes in women with an underlying malignancy. We explored the effectiveness from a societal perspective stratified by age (
