No abstract

BackgroundStudies have shown that vaginal vault prolapse can affect up to 43% of women following hysterectomy for pelvic organ prolapse. Many techniques have been described to prevent and treat vaginal vault prolapse. The primary objective of our study was to compare McCall’s culdoplasty (when performed along side vaginal hysterectomy) with laparoscopic uterosacral plication (when performed along side total laparoscopic hysterectomy) for prevention of vaginal vault prolapse. Secondary outcomes included inpatient stay and perioperative complications.A retrospective comparison study comparing 73 patients who underwent ‘laparoscopic hysterectomy and uterosacral plication’ against 70 patients who underwent ‘vaginal hysterectomy and McCall culdoplasty’. All operations were carried out by two trained surgeons.ResultsThere was no significant difference between BMI or parity. There were statistically significantly more patients presenting with post hysterectomy vault prolapse (PHVP) in the group of patients who had undergone uterosacral plication (12 out of 73) compared with McCalls culdoplasty (0 out of 70) P = 0.000394. Inpatient stay in the uterosacral plication group was significantly shorter mean 1.8 compared to 3.6 for McCall group (P-Value is <0.00001). There was no significance in the perioperative complications between both groups (P = 0.41).ConclusionsMcCalls is a superior operation to prevent PHVP compared to uterosacral plication with no difference in terms of perioperative complications.

No abstract

No abstract

s211 status (RECIST 1.1 responder/non-responder) at a 6-month landmark, we performed Kaplan-Meier analysis of subsequent OS and sensitivity analyses. Time-dependent Cox regressions were also performed. Results: Overall response rate was 19% (56/292) for nivolumab and 12% (36/290) for docetaxel. The number of responders (non-responders) at 6 months was 49 and 26 (132 and 149) among nivolumab and docetaxel patients, respectively. For nivolumab, median post-landmark OS was 12.2 months (95% CI: 9.5-15.1) for non-responders and not reached (NR) (95% CI: 23.9-NR) for responders. For docetaxel, median post-landmark OS was 7.1 months (95% CI: 5.4-9.4) for non-responders and 13.8 months (95% CI: 11.1-28.7) for responders. The hazard ratio between responders and non-responders was 0.24 (95% CI: 0.15-0.39) in the nivolumab arm and 0.55 (95% CI: 0.34-0.88) in the docetaxel arm. Time-dependent Cox analyses showed significantly reduced responders' mortality, and the risk reduction was significantly greater for nivolumab than for docetaxel (p= 0.003). Sensitivity analysis using alternative landmarks yielded qualitatively similar findings. ConClusions: In CheckMate 057, response at 6-months was significantly and positively associated with subsequent survival in both arms; however, the relationship was stronger for nivolumab than for docetaxel. Additionally, non-responders to nivolumab showed a longer median post-landmark survival than non-responders to docetaxel. These findings support incorporating separate response-based survival curves by treatment arm in economic models, especially when comparing an I-O to a non-I-O treatment.