\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[english]{babel}



\usepackage{float}








\begin{document}

\title{Defining optimal rates of surgery in advanced ovarian cancer}



\author[1]{Kathryn Baxter}%
\author[1]{Bryn Russell}%
\author[1]{Amy Hawarden}%
\author[1]{Mary Gee}%
\author[2]{Nardeen Khalil}%
\author[2]{Dominique Jones}%
\author[3]{Vanitha Sivalingam}%
\author[1]{Richard Edmondson}%
\affil[1]{UoM}%
\affil[2]{Manchester University NHS Foundation Trust}%
\affil[3]{University of Manchester}%


\vspace{-1em}



  
  \date{May 24, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Objective The role of surgery for patients with advanced ovarian cancer
is well established but wide variations in the percentage of patients
undergoing surgery exist. Design Observational Study Setting The 19
cancer alliances in England, UK Methods We undertook a comparative
analysis to examine the effects of rates of surgery on one and five year
disease specific survival across the 19 English Cancer Alliances. We
also undertook a propensity score analysis of a single cohort of
patients with advanced ovarian cancer to compare patients who did, and
did not, undergo surgery as part of their primary management. Main
outcome measures Correlations between rates of surgery, demographics,
and cancer alliance performance against one and five year survival
Results In multivariable analysis, rates of surgery undertaken by a
Cancer Alliance remained an independent predictor of both one and five
year survival (correlation coefficient 0.81, and 0.70, respectively)
although this relationship is likely non linear with optimal rates of
surgery still to be defined. Using propensity score analysis a subgroup
of patients who gain no benefit from surgery can be identified.
Conclusions Overall survival of patients with advanced ovarian cancer is
likely to be improved with an increase in overall rates of surgery
however there are likely to be optimal maximal rates, above which
patients will be disadvantaged. Mechanisms for identifying individual
outcome predictions are required.%
\end{abstract}%



\sloppy


\textbf{Hosted file}

\verb`manuscript for original submission v1.docx`  available at \url{https://authorea.com/users/487927/articles/572267-defining-optimal-rates-of-surgery-in-advanced-ovarian-cancer}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/figure-1/figure-1}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/figure-2/figure-2}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/figure-3/figure-3}

\end{center}
\end{figure}

\selectlanguage{english}
\FloatBarrier
\end{document}

