Abstract:
OBJECTIVE:To evaluate the association of sociodemographic and hospital characteristics with adherence to National Comprehensive Cancer Network treatment guidelines for stage IB-IIA cervical cancer and to analyze the relationship between adherent care and survival. METHODS:This is a retrospective population-based cohort study of patients with stage IB-IIA invasive cervical cancer reported to the California Cancer Registry from January 1, 1995, through December 31, 2009. Adherence to National Comprehensive Cancer Network guideline care was defined by year- and stage-appropriate surgical procedures, radiation, and chemotherapy. Multivariate logistic regression, Kaplan-Meier estimate, and Cox proportional hazard models were used to examine associations between patient, tumor, and treatment characteristics and National Comprehensive Cancer Network guideline adherence and cervical cancer-specific 5-year survival. RESULTS:A total of 6,063 patients were identified. Forty-seven percent received National Comprehensive Cancer Network guideline-adherent care, and 18.8% were treated in high-volume centers (20 or more patients/year). On multivariate analysis, lowest socioeconomic status (adjusted odds ratio [OR] 0.69, 95% CI 0.57-0.84), low-middle socioeconomic status (adjusted OR 0.76, 95% CI 0.64-0.92), and Charlson-Deyo comorbidity score 1 or higher (adjusted OR 0.78, 95% CI 0.69-0.89) were patient characteristics associated with receipt of nonguideline care. Receiving adherent care was less common in low-volume centers (45.9%) than in high-volume centers (50.9%) (effect size 0.90, 95% CI 0.84-0.96). Death from cervical cancer was more common in the nonadherent group (13.3%) than in the adherent group (8.6%) (effect size 1.55, 95% CI 1.34-1.80). Black race (adjusted hazard ratio 1.56, 95% CI 1.08-2.27), Medicaid payer status (adjusted hazard ratio 1.47, 95% CI 1.15-1.87), and Charlson-Deyo comorbidity score 1 or higher (adjusted hazard ratio 2.07, 95% CI 1.68-2.56) were all associated with increased risk of dying from cervical cancer. CONCLUSION:Among patients with early-stage cervical cancer, National Comprehensive Cancer Network guideline-nonadherent care was independently associated with increased cervical cancer-specific mortality along with black race and Medicaid payer status. Nonadherence was more prevalent in patients with older age, lower socioeconomic status, and receipt of care in low-volume centers. Attention should be paid to increase guideline adherence.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Pfaendler KS,Chang J,Ziogas A,Bristow RE,Penner KRdoi
10.1097/AOG.0000000000002591subject
Has Abstractpub_date
2018-05-01 00:00:00pages
899-908issue
5eissn
0029-7844issn
1873-233Xpii
00006250-201805000-00021journal_volume
131pub_type
杂志文章abstract::A total of 4517 successful antepartum nonstress tests (NST) was performed on 2003 high- (28%) and low- (72%) risk obstetric patients. Most patients were monitored from 32 to 34 weeks' gestation onward. A reactive NST was defined as 2 accelerations in 10 minutes--15 beats/min minimum amplitude; 15 seconds minimum durat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197907000-00006
更新日期:1979-07-01 00:00:00
abstract::Eighteen patients with mesonephroid ovarian carcinoma were investigated. Typical findings for the mesonephroid tumors were abundant extracellular an some intracellular neutral mucin mixed with sulfate and carboxyl groups, and large amounts of glycogen, especially in clear cells. The latter observation is considered to...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-04-01 00:00:00
abstract::One hundred fifty-eight cases are reported of fetal cardiocentesis during the second trimester for the prenatal diagnosis of hemoglobinopathies. In all cases, fetal blood sampling by funipuncture was technically impossible or unsuccessful. There were nine fetal deaths possibly related to the procedure, for a total fet...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::A prospective ultrasound study was conducted in 289 uncomplicated pregnancies with gestational ages ranging from 16-40 weeks. Biometric measurements obtained included biparietal diameter (BPD), head and abdominal circumferences, measurements of long bones, and maximal transverse colon diameter. The pattern of small in...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:To determine whether women with chorioamnionitis developed elevated serum granulocyte colony-stimulating factor (G-CSF) concentrations and, if so, whether the G-CSF crossed to the fetus. METHODS:We quantified G-CSF before, during, and after delivery and in the cord blood of 12 women with clinical chorioamnio...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00189-x
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVES:Use of prostaglandins, including sulprostone (an E2 analog), is recommended for second-line uterotonic treatment of atonic postpartum hemorrhage and might be considered as an indicator of quality of care in severe atonic postpartum hemorrhage management. Our objective was to estimate whether sulprostone was ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0b013e3182255335
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Heterotopic pregnancy is a rare event in natural conception cycles. Diagnosis of heterotopic pregnancy requires a high index of suspicion. Described herein is a reported case of a heterotopic pregnancy presenting as hematometra. CASE:A young, multiparous woman, with her last menstrual period 6 weeks before ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000142698.17433.cd
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate the value of neural network-directed review of smears determined to contain atypical squamous (glandular) cells of undetermined significance to identify those cases most likely to be associated with cervical intraepithelial neoplasia. METHODS:One hundred sixty smea...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00017-9
更新日期:1998-04-01 00:00:00
abstract::A 10-year retrospective study of acute puerperal inversion of the uterus was undertaken at Women and Infants Hospital of Rhode Island. There were 11 inversions in 70,481 deliveries for an incidence of one in 6407. The age ranged from 19-31 years. Seventy-three percent occurred in nulliparous women. All cases were reco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::We previously reported surgical correction of vaginal agenesis and partial cervical atresia in an 11-year-old girl with amenorrhea and a pelvic mass. This patient, the subject of this report, conceived 7 years later and delivered at term. An abdominal cerclage was placed at 12 weeks' gestation to protect the cervix, a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199011001-00001
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To determine the association between pretreatment platelet count and survival in women with stage IB cervical cancer. METHODS:Clinical records were reviewed for 219 women with stage IB cervical cancer treated by radical hysterectomy from 1971-1984. Univariate and multivariate analyses were performed to ident...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:To determine whether the risk for uterine rupture is increased in women attempting vaginal birth after multiple cesarean deliveries. METHODS:We conducted a prospective multicenter observational study of women with prior cesarean delivery undergoing trial of labor and elective repeat operation. Maternal and p...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.AOG.0000224694.32531.f3
更新日期:2006-07-01 00:00:00
abstract::Indium-111 attached to bleomycin is useful in the scintigraphic localization of a variety of tumors. Since it does not normally accumulate in bowel and feces, it is superior to other radiopharmaceuticals, such as gallium-67 citrate, in the demonstration of abnormalities in the abdomen and pelvis. Twenty-eight patients...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-09-01 00:00:00
abstract:OBJECTIVE:To determine whether glucagon has relaxant effects on the spontaneous contractions of term pregnant human uterine smooth muscle in an isolated preparation. METHODS:Myometrial specimens were excised from the upper incisional surface of the lower uterine segment in seven women during elective cesarean delivery...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00283-9
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:To investigate neonatal morbidity and maternal complication rates with delivery body mass index (BMI) 60 or greater. METHODS:This retrospective, multicenter cohort study included singleton pregnancies between 23 and 42 weeks of gestation from January 2005 to April 2016. Women with BMI 60 or greater were comp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/AOG.0000000000002316
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Tension-free vaginal tape procedure is a popular surgical treatment of genuine stress urinary incontinence. CASES:Two cases of retropubic hematoma after tension-free vaginal tape procedure are reported. One woman with an 8 x 10 cm hematoma localized to the retropubic space required transfusion of two units ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01560-5
更新日期:2001-11-01 00:00:00
abstract::Sixty-two cases of oligohydramnios diagnosed by ultrasound between 13-28 weeks' gestation were reviewed. Three experienced ultrasonographers used a subjective scale to rate the oligohydramnios as mild, moderate, severe, or anhydramniotic. Interobserver reliability was excellent (intraclass correlation coefficient 0.81...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVE:To compare blood loss, operative time, postoperative pain medication requirements, and complication rates in patients undergoing vaginal hysterectomy who were randomly assigned to receive preoperative intracervical vasopressin or no intracervical injection. METHODS:Fifty-eight women undergoing vaginal hyster...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0b013e3181954c44
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Adult females with menorrhagia may have unrecognized mild von Willebrand's disease. Most females with known von Willebrand's disease report menorrhagia. CASE:A 38-year-old healthy female desired contraception. She described heavy menses lasting 8 days since menarche. History included uncomplicated vaginal d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000157758.94890.59
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To compare tubal anastomosis by robotic system compared with outpatient minilaparotomy. METHODS:In this retrospective case-control study, women were identified by current procedural terminology code for tubal anastomosis. We included all cases of tubal anastomosis for reversal of a prior tubal ligation by ei...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000264591.43544.0f
更新日期:2007-06-01 00:00:00
abstract::We present a series of 20 patients who underwent uterine suspension performed through a laparoscope, as part of conservative treatment for infertility and pelvic pain. The operative technique is easily mastered by a skilled laparoscopist who is prepared to deal with intra- or postoperative complications. Avulsion of t...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-197805000-00011
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVE:To examine possible changes in cardiac function in fetuses of pregestational diabetic mothers. METHODS:We conducted a prospective longitudinal study of 31 women whose pregnancies were between 22 weeks' gestation and term, and who had pregestational diabetes. All diabetic women included in the study had glyco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00003-4
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To assess changes in the prescribing practices, knowledge, attitudes, and perceptions of health care providers after an educational program about emergency contraception. METHODS:Health care providers completed self-administered questionnaires before and 1 year after full implementation of the project. The 1...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01365-5
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVE:To describe recent syphilis trends among pregnant women and to evaluate the prevalence of reported high-risk behaviors in this population. METHODS:We analyzed U.S. national case report data for 2012-2016 to assess trends among pregnant women with all stages of syphilis. Risk behavior data collected through c...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003000
更新日期:2019-01-01 00:00:00
abstract::Mothers of children with Down syndrome were surveyed by questionnaire concerning their attitudes about amniocentesis, prenatal genetic counseling, and abortion. Of the 101 who responded, 40 had borne children after giving birth to a child with Down syndrome. Half had amniocentesis in subsequent pregnancies but only ha...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-08-01 00:00:00
abstract:BACKGROUND:Pellagra is a rare clinical syndrome caused by niacin deficiency, and although most commonly nutritional in origin, may be secondary to carcinoid syndrome. CASE:A premenopausal nulliparous woman with metastatic carcinoid tumor developed isolated vulvovaginal manifestations characterized by well-demarcated s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318191bb51
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To analyze X inactivation in women with recurrent miscarriage to estimate whether skewed X inactivation is associated with recurrent miscarriage and whether it predicts next pregnancy outcomes. METHODS:A multicenter study was performed. A power calculation determined that 101 patients were needed to detect a...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/s0029-7844(03)00345-4
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:Reducing tobacco use in pregnancy is a public health priority. Brief smoking counseling during prenatal care is effective but generates modest cessation rates. Telephone counseling is an effective smoking cessation method that could offer pregnant women convenient access to more intensive smoking cessation co...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.AOG.0000218100.05601.f8
更新日期:2006-07-01 00:00:00
abstract::When any fetal blood group factor inherited from the father is not possessed by the mother, antepartum or intrapartum fetal-maternal bleeding may stimulate an immune reaction in the mother Maternal immune reactions also can occur from blood product transfusion. The formation of maternal antibodies, or"alloimmunization...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/00006250-200608000-00044
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Bombay blood type is among the rarest in the world and is associated with anti-H antibodies. These antibodies cause severe hemolysis when exposed to any blood product except Bombay and have been reported to cause hemolytic disease of the newborn. CASE:A primigravid woman with Bombay blood type received eryt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181f738f3
更新日期:2011-02-01 00:00:00