OBJECTIVE: To estimate the incidence of occult uterine sarcoma and leiomyosarcoma in hysterectomies for leiomyomas and the risk associated with their morcellation. METHODS: We conducted a population-based cohort study. All uterine sarcomas from 2006-2013 in an integrated health care system were identified. Age- and race-specific incidences of occult uterine sarcoma were calculated. Kaplan-Meier survival analysis was performed. Crude and adjusted risk ratios of recurrence and death associated with morcellation at 1, 2, and 3 years were estimated using Poisson regression with inverse probability weighting. RESULTS: There were 125 hysterectomies with occult uterine sarcomas identified among 34,728 hysterectomies performed for leiomyomas. The incidence of occult uterine sarcoma and leiomyosarcoma was 1 of 278 or 3.60 (95% confidence interval [CI] 2.97-4.23) and 1 of 429 or 2.33 (95% CI 1.83-2.84) per 1,000 hysterectomies. For stage I leiomyosarcoma (n=111), eight (7.2%) were power and 27 (24.3%) nonpower-morcellated. The unadjusted 3-year probability of disease-free survival for no morcellation, power and nonpower morcellation was 0.54, 0.19, and 0.51, respectively (P=.15); overall survival was 0.64, 0.75, and 0.68, respectively (P=.97). None of the adjusted risk ratios for recurrence or death were significant except for death at 1 year for power and nonpower morcellation groups combined (6/33) compared with no morcellation (4/76) (5.12, 95% CI 1.33-19.76, P=.02). We had inadequate power to infer differences for all other comparisons including 3-year survival and power morcellation. CONCLUSION: Morcellation is associated with decreased early survival of women with occult leiomyosarcomas. We could not accurately assess associations between power morcellation and 3-year survival as a result of small numbers.
OBJECTIVE: To estimate the incidence of occult uterine sarcoma and leiomyosarcoma in hysterectomies for leiomyomas and the risk associated with their morcellation. METHODS: We conducted a population-based cohort study. All uterine sarcomas from 2006-2013 in an integrated health care system were identified. Age- and race-specific incidences of occult uterine sarcoma were calculated. Kaplan-Meier survival analysis was performed. Crude and adjusted risk ratios of recurrence and death associated with morcellation at 1, 2, and 3 years were estimated using Poisson regression with inverse probability weighting. RESULTS: There were 125 hysterectomies with occult uterine sarcomas identified among 34,728 hysterectomies performed for leiomyomas. The incidence of occult uterine sarcoma and leiomyosarcoma was 1 of 278 or 3.60 (95% confidence interval [CI] 2.97-4.23) and 1 of 429 or 2.33 (95% CI 1.83-2.84) per 1,000 hysterectomies. For stage I leiomyosarcoma (n=111), eight (7.2%) were power and 27 (24.3%) nonpower-morcellated. The unadjusted 3-year probability of disease-free survival for no morcellation, power and nonpower morcellation was 0.54, 0.19, and 0.51, respectively (P=.15); overall survival was 0.64, 0.75, and 0.68, respectively (P=.97). None of the adjusted risk ratios for recurrence or death were significant except for death at 1 year for power and nonpower morcellation groups combined (6/33) compared with no morcellation (4/76) (5.12, 95% CI 1.33-19.76, P=.02). We had inadequate power to infer differences for all other comparisons including 3-year survival and power morcellation. CONCLUSION: Morcellation is associated with decreased early survival of women with occult leiomyosarcomas. We could not accurately assess associations between power morcellation and 3-year survival as a result of small numbers.
Authors: Xiao Xu; Haiqun Lin; Jason D Wright; Cary P Gross; Francis P Boscoe; Lindsey M Hutchison; Peter E Schwartz; Vrunda B Desai Journal: J Clin Oncol Date: 2019-09-16 Impact factor: 44.544
Authors: David B Chapel; Aarti Sharma; Ricardo R Lastra; Livia Maccio; Emma Bragantini; Gian Franco Zannoni; Suzanne George; Bradley J Quade; Carlos Parra-Herran; Marisa R Nucci Journal: Mod Pathol Date: 2022-02-04 Impact factor: 7.842
Authors: Francesco Multinu; Jvan Casarin; Lucia Tortorella; Yajue Huang; Amy Weaver; Stefano Angioni; Gian Benedetto Melis; Andrea Mariani; Elizabeth A Stewart; Shannon K Laughlin-Tommaso Journal: Am J Obstet Gynecol Date: 2018-11-14 Impact factor: 8.661
Authors: Dominik Denschlag; Sven Ackermann; Marco Johannes Battista; Wolfgang Cremer; Gerlinde Egerer; Markus Follmann; Heidemarie Haas; Philipp Harter; Simone Hettmer; Lars-Christian Horn; Ingolf Juhasz-Boess; Karin Kast; Günter Köhler; Thomas Kröncke; Katja Lindel; Peter Mallmann; Regine Meyer-Steinacker; Alexander Mustea; Edgar Petru; Peter Reichardt; Dietmar Schmidt; Hans-Georg Strauss; Clemens Tempfer; Falk Thiel; Uwe Ulrich; Thomas Vogl; Dirk Vordermark; Paul Gass; Matthias W Beckmann Journal: Geburtshilfe Frauenheilkd Date: 2019-10-22 Impact factor: 2.915
Authors: Rosanne M Kho; Vrunda B Desai; Peter E Schwartz; Jason D Wright; Cary P Gross; Lindsey M Hutchison; Francis P Boscoe; Haiqun Lin; Xiao Xu Journal: J Minim Invasive Gynecol Date: 2021-07-13 Impact factor: 4.137