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\begin{document}

\title{Variation in Outcome Reporting Identified in Studies of
Fertility-Sparing Surgery for Cervical Cancer: a Systematic Review}



\author[1]{Nathanael Yong}%
\author[2]{Natalie  Cooper}%
\author[3]{Sarah Yorke}%
\author[4]{Chawan Baran}%
\author[5]{Khalid Khan}%
\author[6]{Alex Tan}%
\author[7]{Michail Sideris}%
\author[8]{Stamatina Iliodromiti}%
\author[9]{Ranjit Manchanda}%
\affil[1]{Royal Surrey County Hospital NHS Foundation Trust}%
\affil[2]{Barts and The London School of Medicine and Dentistry Blizard Institute}%
\affil[3]{Queen Mary University Institute of Population Health Sciences}%
\affil[4]{Barts Health NHS Trust}%
\affil[5]{University of Granada}%
\affil[6]{Royal Surrey NHS Foundation Trust}%
\affil[7]{Queen Mary University of London}%
\affil[8]{QMUL}%
\affil[9]{Wolfson Institute of Population Health, Queen Mary University of London}%


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  \date{May 24, 2024}


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\begin{abstract}
Background: Cervical cancer affects 3,197 women in the UK, and 604000
women worldwide annually, with peak incidence seen between 30-34 years
of age. For many, fertility-sparing surgery is an appealing option where
possible. However, absence of large-scale data, along with a notable
variation in reported outcomes in relevant studies may undermine future
efforts for consistent evidence synthesis. Objectives: To systematically
review the reported outcomes measured in studies that include women who
underwent fertility-sparing surgery for cervical cancer and identify
whether variation exists. Search Strategy: We searched MEDLINE, EMBASE,
and CENTRAL from inception to February 2019. Selection Criteria:
Randomised controlled trials, cohort and observational studies, and case
studies of more than 10 participants from January 1990 to date. Data
Collection and Analysis: Study characteristics and all reported
treatment outcomes. Main results: 104 studies with a sum of 9535
participants were identified. Most studies reported on oncological
outcomes (97/104), followed by fertility and pregnancy (86/104),
post-operative complications (74/104), intra-operative complications
(72/104), and quality of life (5). There were huge variation and
heterogeneity in reported outcomes, with only 12\% being good quality
and 87\% being of poor quality. Conclusions: There is significant
heterogeneity in the reported outcomes. An agreed Core Outcome Set (COS)
is necessary for future studies to effectively harmonise reported
outcomes that are measurable and relevant to patients, clinicians, and
researchers. This systematic review sets the groundwork for the
development of a COS for fertility sparing surgery in cervical cancer.
Funding: British Medical Association's Strutt and Harper Grant.%
\end{abstract}%



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