Researchers at the Barbara Ann Karmanos Cancer Institute completed a study that looks at the rate of concurrent surgery for locoregional gynecologic cancers and pelvic organ prolapse-urinary incontinence (POP-UI), as well as the rate of surgery for patients who have POP-UI but did not get the surgery concurrently with the removal of their cancer. Understanding that many gynecologic oncology patients also have risk factors for pelvic floor disorders, including obesity and age, scientists wanted to know if it would benefit the patient to have both procedures simultaneously. Their study, “Concurrent surgery for locoregional gynecologic cancers and pelvic floor disorders in a population of patients with Medicare insurance,” is listed on the cover of the April publication of Obstetrics and Gynecology.
“Previously published literature had established that concurrent surgery for gynecologic cancer and pelvic floor disorders was feasible and safe, but it was unclear as to how often these surgeries were performed together in practice,” explained Logan Corey, M.D., a gynecologic oncology fellow at the Barbara Ann Karmanos Cancer Institute and Wayne State University (WSU) School of Medicine.
Corey trains with Ira Winer, M.D., Ph.D., FACOG, gynecologic oncologist, Gynecologic Oncology and Phase 1 Clinical Trials Multidisciplinary Teams member, and Molecular Therapeutics Research Program member at Karmanos. Dr. Winer is the senior and corresponding author of the study.
The team used the SEER-Medicare database to collect data by diagnosis, procedure codes and pelvic floor disorder identifiers. They found over 30,000 patients who fit the criteria they were looking for.
From that data, they discovered that around 5.5% of the patients who had surgery for gynecologic cancer also had concurrent surgery for pelvic floor disorders. Those diagnosed with pelvic floor disorders before their cancer diagnosis had simultaneous surgery at a higher rate (21%) than those without a known diagnosis.
“This is important because 5% of those patients with pelvic floor disorders and gynecologic cancers who only underwent surgery for their cancer ultimately underwent a second surgery for their pelvic floor disorder within five years,” added Dr. Corey.
The authors suggest future directions will be identifying patients who benefit from concurrent surgery, determining why these simultaneous procedures do not occur, and investigating how adjuvant treatment for gynecologic cancers, including chemotherapy and radiation, affects the development of pelvic floor disorders.
Additional co-authors on this paper include Randell Seaton, MPH, WSU School of Medicine; Julie J. Ruterbusch, MPH, director of the Epidemiology Research Core (ERC) and member of the Population Studies and Disparities Research Program at Karmanos; Carol Emi Bretschneider, M.D., Northwestern Medicine; Alex Vezina, M.D., Ochsner Clinic Foundation; Trieu Do, M.D., who at the time of this publication was a resident in the Department of Obstetrics & Gynecology, WSU School of Medicine; and Deslyn Hobson, M.D., urogynecologist, WSU School of Medicine. This study was supported by the ERC and the National Cancer Institute grant awarded to Karmanos and WSU.
Read the study here.