Publications by authors named "J A Tidy"
Article Synopsis
- The SHAPE trial showed that simple hysterectomy is just as effective as radical hysterectomy in preventing pelvic recurrence in low-risk early-stage cervical cancer, but offers better quality of life and sexual health.
- A cost-effectiveness analysis using a Markov model over 5 years found that simple hysterectomy costs less ($11,022) and provides more quality-adjusted life years (3.56 QALYs) compared to radical hysterectomy ($12,533 and 3.54 QALYs).
- The study concluded that simple hysterectomy is a better option overall due to being more cost-effective and yielding a higher quality of life post-surgery.
Article Synopsis
- The SHAPE trial studied the effects of simple hysterectomy compared to radical hysterectomy on sexual health and quality of life in women with low-risk cervical cancer.
- Participants were assessed up to 36 months after surgery using specific questionnaires to measure sexual function and overall well-being.
- Results showed that simple hysterectomy led to better sexual health outcomes and quality of life, with lower rates of sexual dysfunction and greater global health status compared to radical hysterectomy.
Background: Retrospective data suggest that the incidence of parametrial infiltration is low in patients with early-stage low-risk cervical cancer, which raises questions regarding the need for radical hysterectomy in these patients. However, data from large, randomized trials comparing outcomes of radical and simple hysterectomy are lacking.
Methods: We conducted a multicenter, randomized, noninferiority trial comparing radical hysterectomy with simple hysterectomy including lymph-node assessment in patients with low-risk cervical cancer (lesions of ≤2 cm with limited stromal invasion).
Objective: The International Federation of Gynecology and Obstetrics (FIGO) scoring system uses the sum of eight risk-factors to predict single-agent chemotherapy resistance in Gestational Trophoblastic Neoplasia (GTN). To improve ease of use, this study aimed to generate: (i) streamlined models that match FIGO performance and; (ii) visual-decision aids (nomograms) for guiding management.
Methods: Using training (n = 4191) and validation datasets (n = 144) of GTN patients from two UK specialist centres, logistic regression analysis generated two-factor models for cross-validation and exploration.
Background: Approximately one-third of patients with low-risk Gestational Trophoblastic Neoplasia (WHO 0-6) develop methotrexate-resistance (MTX-R). In the UK, subsequent treatment with either actinomycin-D (ActD) or multi-agent combination chemotherapy has depended on whether the hCG was above or below an hCG threshold. To reduce exposure to combination chemotherapy (CC), over the years the UK service has raised this threshold as well as using single-agent carboplatin AUC6 3-weekly at MTX-R instead of CC.
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