Effect of tumor morcellation in patients with early uterine sarcoma: a multicenter study in Germany
Morcellation
unexpected malignancy
sarcoma
laparoscopy
survival rate
Journal
Journal of the Turkish German Gynecological Association
ISSN: 1309-0399
Titre abrégé: J Turk Ger Gynecol Assoc
Pays: Turkey
ID NLM: 101272522
Informations de publication
Date de publication:
01 06 2022
01 06 2022
Historique:
entrez:
10
3
2022
pubmed:
11
3
2022
medline:
11
3
2022
Statut:
ppublish
Résumé
The use of power morcellation at laparoscopy may worsen survival rates for patients with malignancy. The aim of the present study was to report the outcome of patients with early-stage uterine sarcoma after morcellation or total en-bloc resection, and evaluate potential signs of sarcoma preoperatively. This multicenter retrospective study consisted of patients, who underwent surgery for FIGO-stage-1 uterine sarcoma. Twenty-four patients were divided into a non-morcellation group and a morcellation group. Clinical records and the outcomes of patients, including one-, three- and five-year survival rates were reviewed. Preoperative characteristics of patients with sarcoma were compared to those of a control group with uterine myoma (1:4 ratio), matched by age and type of operation. Obesity was an independent risk factor for uterine myoma. Tumor growth, solitary growth, largest-diameter lesion >8.0 cm, and anechoic areas suggesting necrosis and increased vascularization were significantly more common in the sarcoma group. A large tumor diameter was significantly associated with mortality. Patients in the non-morcellation group had a slightly lower disease-free survival, but poorer overall survival (OS) rates compared to patients in the morcellation group, but neither difference was statistically significant. Patients in the non-morcellation group, who had undergone a re-exploration experienced late recurrence, but no upstaging was evident after the operation. Preoperative ultrasound characteristics could be useful to distinguish sarcoma from leiomyoma of uterus. Morcellation of a sarcoma may increase abdominal and pelvic recurrence rates, but may not be associated with OS in patients with FIGO-stage-1 disease.
Identifiants
pubmed: 35263843
doi: 10.4274/jtgga.galenos.2022.2021.9-17
pmc: PMC9161007
doi:
Types de publication
Journal Article
Langues
eng
Pagination
75-82Informations de copyright
©Copyright 2022 by the Turkish-German Gynecological Education and Research Foundation
Déclaration de conflit d'intérêts
Conflict of Interest: No conflict of interest is declared by the authors.
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