Morcellation worsens survival outcomes in patients with undiagnosed uterine leiomyosarcomas: A retrospective MITO group study

Giovanni Scambia, Domenica Lorusso, Francesco Raspagliesi, Giuseppa Maltese, Giorgio Bogani, Giovanni Fucà, Stefano Lepori, Pierandrea De Iaco, Myriam Perrone, Gennaro Cormio, Stefano Bogliolo, Alice Bergamini, Giuseppe Bifulco, Paolo Giovanni Casali

Risultato della ricerca: Contributo in rivistaArticolo in rivista

45 Citazioni (Scopus)

Abstract

Objective To investigate the impact of morcellation on survival outcomes of patients affected by undiagnosed uterine sarcoma. Methods This is a retrospective study performed in 8 referral centers of MITO group. Data of women undergoing morcellation for apparent benign uterine myomas who were ultimately diagnosed with stage I uterine sarcoma on final pathology were compared with data of women who did not undergo morcellation. Uterine sarcoma included: leiomyosarcomas (LMS), smooth muscle tumors of uncertain malignant potential (STUMP), low-grade endometrial stromal sarcomas (LG-ESS) and undifferentiated uterine sarcomas (UUS). Two-year survival outcomes were evaluated using Kaplan-Meir and Cox models. Results Overall 125 patients were identified: 31(24.8%), 21(16.8%) and 73(58.4%) patients had power morcellation during laparoscopy, non power morcellation during open surgery and non morcellation during open procedures, respectively. Considering patients affected by LMS, morcellation did not correlated with disease-free survival. However, patients undergoing either morcellation or power morcellation experienced a 3-fold increase risk of death in comparison to patients who had not morcellation (p = 0.02). A trend towards an increase of recurrence was observed for patients undergoing morcellation for STUMP (HR 7.7, p = 0.09); while no differences in survival outcomes were observed for patients with LG-ESS and UUS. Conclusions Our data suggest that morcellation increase the risk of death in patients affected by undiagnosed LMS. Further prospective studies are warranted in order to assess the risk to benefit ratio of power morcellator utilization in patients with apparent benign uterine myomas.
Lingua originaleEnglish
pagine (da-a)90-95
Numero di pagine6
RivistaGynecologic Oncology
Volume144
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Adult
  • Disease-Free Survival
  • Female
  • Humans
  • Laparoscopy
  • Leiomyoma
  • Leiomyosarcoma
  • Middle Aged
  • Morcellation
  • Myoma
  • Obstetrics and Gynecology
  • Oncology
  • Retrospective Studies
  • Sarcoma
  • Smooth Muscle Tumor
  • Survival
  • Uterine Neoplasms

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