2023
Black-White differences in uterine cancer symptomatology and stage at diagnosis
Xu X, Chen L, Nunez-Smith M, Clark M, Ferris J, Hershman D, Wright J. Black-White differences in uterine cancer symptomatology and stage at diagnosis. Gynecologic Oncology 2023, 180: 118-125. PMID: 38091770, PMCID: PMC10922746, DOI: 10.1016/j.ygyno.2023.11.029.Peer-Reviewed Original ResearchAdvanced stage diagnosisWhite patientsPostmenopausal bleedingPatient characteristicsEnd Results-Medicare databaseBlack-white differencesBlack-White disparitiesBlack patientsUterine cancerCancer symptomsHigh riskPatientsAdvanced stageSymptomsDiagnosisCancer symptomatologyRegression modelsRiskLarge proportionBleedingHistologyCancerEpidemiologySymptomatologyMonthsTimeliness of diagnostic evaluation for postmenopausal bleeding: A retrospective cohort study using claims data
Xu X, Chen L, Nunez-Smith M, Clark M, Wright J. Timeliness of diagnostic evaluation for postmenopausal bleeding: A retrospective cohort study using claims data. PLOS ONE 2023, 18: e0289692. PMID: 37682914, PMCID: PMC10490884, DOI: 10.1371/journal.pone.0289692.Peer-Reviewed Original ResearchConceptsPostmenopausal bleedingFirst diagnostic procedureDiagnostic evaluationDiagnostic proceduresGynecologic conditionsMedicaid patientsCox proportional hazards modelPrompt diagnostic evaluationRetrospective cohort studyMarketScan Research DatabasesAdditional risk factorsNon-clinical factorsCommon gynecologic conditionProportional hazards modelLower ratesCohort studyMost patientsPatient characteristicsBenign etiologyGynecologic cancerCancer patientsPreventive careUterine cancerInsurance typeRisk factorsRacial disparities in diagnostic evaluation of uterine cancer among Medicaid beneficiaries
Xu X, Chen L, Nunez-Smith M, Clark M, Wright J. Racial disparities in diagnostic evaluation of uterine cancer among Medicaid beneficiaries. Journal Of The National Cancer Institute 2023, 115: 636-643. PMID: 36788453, PMCID: PMC10248843, DOI: 10.1093/jnci/djad027.Peer-Reviewed Original ResearchConceptsAbnormal uterine bleedingWhite patientsUterine cancerFirst diagnostic procedureDiagnostic evaluationBlack patientsDiagnostic proceduresBlack-White disparitiesManagement visitsMarketScan Multi-State Medicaid DatabaseMulti-State Medicaid DatabaseUterine bleedingPatient characteristicsMedicaid databaseEarly diagnosisMedicaid beneficiariesMultivariable regressionPatientsCancerRacial disparitiesDiagnosisVisitsMore evaluationDisparitiesBleeding
2020
Unanticipated Uterine and Cervical Malignancy in Women Undergoing Hysterectomy for Uterovaginal Prolapse.
Andiman SE, Bui AH, Hardart A, Xu X. Unanticipated Uterine and Cervical Malignancy in Women Undergoing Hysterectomy for Uterovaginal Prolapse. Urogynecology 2020, 27: e549-e554. PMID: 33208657, DOI: 10.1097/spv.0000000000000990.Peer-Reviewed Original ResearchConceptsMultivariable logistic regressionUterovaginal prolapseUterine cancerCervical cancerSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramLogistic regressionUnexpected uterine malignancyQuality Improvement ProgramSample eligibility criteriaPathology-confirmed diagnosisUterine malignanciesRadical hysterectomyTotal hysterectomyPatient characteristicsUterine weightCervical malignancyGynecologic cancerOutcome measuresHysterectomyAmerican CollegeEligibility criteriaBivariate statistical testsConcurrent procedures
2019
Association Between Power Morcellation and Mortality in Women With Unexpected Uterine Cancer Undergoing Hysterectomy or Myomectomy.
Xu X, Lin H, Wright JD, Gross CP, Boscoe FP, Hutchison LM, Schwartz PE, Desai VB. Association Between Power Morcellation and Mortality in Women With Unexpected Uterine Cancer Undergoing Hysterectomy or Myomectomy. Journal Of Clinical Oncology 2019, 37: 3412-3424. PMID: 31518176, PMCID: PMC6901279, DOI: 10.1200/jco.19.00562.Peer-Reviewed Original ResearchConceptsTotal abdominal hysterectomyOccult uterine sarcomaUncontained power morcellationDisease-specific mortalityOccult uterine cancerSupracervical abdominal hysterectomyPower morcellationOccult endometrial carcinomaAbdominal hysterectomyUterine sarcomaUterine cancerEndometrial carcinomaMortality riskMultivariable Cox regressionPrognosis of patientsSubset of womenTime of hysterectomyHospital discharge recordsCancer registry dataHigher mortality riskOccult leiomyosarcomaCause mortalityLaparoscopic myomectomyPatient characteristicsBenign indicationsLaparoscopic Hysterectomy Route, Resource Use, and Outcomes: Change After Power Morcellation Warning.
Desai VB, Wright JD, Lin H, Gross CP, Sallah YH, Schwartz PE, Xu X. Laparoscopic Hysterectomy Route, Resource Use, and Outcomes: Change After Power Morcellation Warning. Obstetrics And Gynecology 2019, 134: 227-238. PMID: 31348209, DOI: 10.1097/aog.0000000000003375.Peer-Reviewed Original ResearchConceptsLaparoscopic supracervical hysterectomyTotal laparoscopic hysterectomyLaparoscopic hysterectomySupracervical hysterectomySurgical outcomesFDA warningOperative timeSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramLength of stayInterrupted time series analysisQuality Improvement ProgramHysterectomy routePatient characteristicsBenign indicationsInpatient stayPower morcellationPatient outcomesHysterectomyAmerican CollegeSurgical settingU.S. FoodOutcomesStayPrevalence, characteristics, and risk factors of occult uterine cancer in presumed benign hysterectomy
Desai VB, Wright JD, Gross CP, Lin H, Boscoe FP, Hutchison LM, Schwartz PE, Xu X. Prevalence, characteristics, and risk factors of occult uterine cancer in presumed benign hysterectomy. American Journal Of Obstetrics And Gynecology 2019, 221: 39.e1-39.e14. PMID: 30853364, PMCID: PMC7006101, DOI: 10.1016/j.ajog.2019.02.051.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAsianBlack or African AmericanComorbidityEndometrial NeoplasmsEndometriosisEthnicityFemaleHispanic or LatinoHumansHysterectomyIncidental FindingsLeiomyomaLeiomyosarcomaMenstruation DisturbancesMetrorrhagiaMiddle AgedObesityPrevalenceRisk AssessmentRisk FactorsSarcomaUnited StatesUterine NeoplasmsUterine ProlapseWhite PeopleYoung AdultConceptsOccult uterine cancerUterine cancerBenign indicationsRisk factorsUterine sarcomaBenign hysterectomyEndometrial carcinomaPredictive valueResearch Cooperative System databaseState cancer registry dataNew York Statewide PlanningHigh negative predictive valueLow positive predictive valueAssociated risk factorsCorpus uteri cancerLarge population-based sampleCancer registry dataPopulation-based sampleAmbulatory surgery centersNegative predictive valuePositive predictive valueRisk prediction modelRace/ethnicityPostmenopausal bleedingPatient characteristics
2017
Perceived Stress After Acute Myocardial Infarction
Xu X, Bao H, Strait KM, Edmondson DE, Davidson KW, Beltrame JF, Bueno H, Lin H, Dreyer RP, Brush JE, Spertus JA, Lichtman JH, D'Onofrio G, Krumholz HM. Perceived Stress After Acute Myocardial Infarction. Psychosomatic Medicine 2017, 79: 50-58. PMID: 27984507, PMCID: PMC5459399, DOI: 10.1097/psy.0000000000000429.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPSS-14 scoreMiddle-aged patientsPatient characteristicsMyocardial infarctionSex differencesMonths of recoveryAMI anginaInitial hospitalizationPerceived Stress ScalePatientsAnginaLess improvementLinear mixed-effects modelsFirst monthPsychological stressMixed-effects modelsWomenMonthsHigh levelsMenInfarctionStress ScalePerceived stress