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Segarra-Vidal B, Dinoi G, Zorrilla-Vaca A, Mariani A Student V, Garcia NA, et al. Minimally invasive compared with open hysterectomy in high-risk endometrial cancer. Obstet Gynecol 2021;138.

The authors provided this information as a supplement to their article.

Appendix 1. Comparing the Distribution of the Year of Surgery Between Open and Minimally Invasive Surgery in the Pre- Matching Cohort

Year of Surgery Open (n=363)

MIS (n=263)

P value

1999 15 (4.1) 0 (0.0) < 0.001

2000 11 (3.0) 0 (0.0) 0.005

2001 20 (5.5) 0 (0.0) < 0.001

2002 36 (9.9) 0 (0.0) < 0.001

2003 26 (7.2) 0 (0.0) < 0.001

2004 30 (8.3) 1 (0.4) < 0.001

2005 31 (8.5) 2 (0.8) < 0.001

2006 18 (4.9) 4 (1.5) 0.022

2007 27 (7.4) 6 (2.3) 0.005

2008 25 (6.9) 12 (4.6) 0.229

2009 20 (5.5) 22 (8.5) 0.140

2010 24 (6.6) 20 (7.7) 0.596

2011 36 (9.9) 16 (6.2) 0.099

2012 19 (5.2) 29 (11.1) 0.006

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2013 11 (3.0) 50 (19.2) < 0.001

2014 8 (2.2) 52 (20.0) < 0.001

2015 4 (1.1) 34 (13.1) < 0.001

2016 2 (0.6) 12 (4.6) 0.001

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Appendix 2. Comparing the Distribution of the Year of Surgery Between Open and Minimally Invasive Surgery in the Post- matching Cohort

Year of Surgery Open (n=185)

MIS (n=185)

P value

1999 5 (2.7) 0 (0.0) 0.024

2000 3 (1.6) 0 (0.0) 0.084

2001 7 (3.8) 0 (0.0) 0.007

2002 18 (9.7) 0 (0.0) < 0.001

2003 13 (7.0) 0 (0.0) 0.002

2004 15 (8.1) 1 (0.5) 0.003

2005 12 (6.5) 2 (1.1) 0.007

2006 9 (4.9) 3 (1.6) 0.074

2007 11 (5.9) 6 (3.2) 0.213

2008 13 (7.0) 10 (5.4) 0.523

2009 15 (8.1) 20 (10.8) 0.375

2010 13 (7.0) 19 (10.3) 0.259

2011 24 (12.9) 16 (8.7) 0.193

2012 11 (5.9) 27 (14.6) 0.006

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2013 7 (3.8) 42 (22.7) < 0.001

2014 4 (2.2) 25 (13.5) < 0.001

2015 3 (1.6) 11 (5.9) 0.029

2016 2 (1.1) 3 (1.6) 0.677

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Appendix 3. Assessment of the balance of the model. This calculation was performed in Stata 14.0, which integrates independent variables (e.g., elderly, comorbidities, neoadjuvant therapy, lymphatic mapping) and the dependent variable (disease-free survival). This regression result in the assignation of propensity scores to each study subject, representing the probability that an event occurs (laparoscopic vs open surgery) given the presence of patient variables (e.g., elderly, cancer classification, radiotherapy, chemotherapy), which allow us to balance confounding bias between two different cohorts of patients.

BEFORE MATCHING

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AFTER MATCHING

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Appendix 4. Percentage of bias influenced by the covariates.

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Appendix 5. Uterine manipulator versus no uterine manipulator in minimally invasive surgery group. Panel A represents cumulative incidence of recurrence, Panel B represents disease free survival, and Panel C represents overall survival.

A

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B

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C

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Appendix 6. Outcomes for Uterine Manipulator in the Minimally Invasive Surgery Group

Outcome No uterine

manipulator (n=102)

Uterine Manipulator

(n=83)

P value

DFS at 2 years, % (95% CI) 77.5% (66.7-85.2) 68.3% (62.4-73.5) 0.64 DFS at 5 years, % (95% CI) 62.4% (50.4-72.3) 65.6% (59.5-71.1) 0.73 OS at 2 years, % (95% CI) 90.4% (81.7-95.1) 84.8% (80.1-88.5) 0.45 OS at 5 years, % (95% CI) 72.5% (61.3-80.9) 69.9% (64.1-75.1) 0.29 Recurrence at 2 years, % (95%

CI)

17.9% (11.1-28.4) 23.8% (19.2-29.6) 0.19

Recurrence at 5 years, % (95%

CI)

35.9% (25.9-48.4) 35.8% (30.1-42.2) 0.54

Days to recurrence (months), median (IQR)

21 (11.4-43.8) 16 (6.3-25.6) 0.03

DFS: disease-free survival; OS: overall survival