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Is There Negative Impact from Morcellation in Unsuspected Leiomyosarcoma?
Abstract & Commentary
By Robert L. Coleman, MD , Professor, University of Texas; M.D. Anderson Cancer Center, Houston, is Associate Editor for OB/GYN Clinical Alert .
Dr. Coleman reports no financial relationship to this field of study.
Synopsis: Uterine morcellation procedures are common in the management of uterine leiomyomata, but may adversely impact outcomes and patterns of recurrence when performed in the setting of leiomyosarcoma.
Source: Park JY, et al. The impact of tumor morcellation during surgery on the prognosis of patients with apparently early uterine leiomyosarcoma. Gynecol Oncol 2011, doi:10.1016/j.ygynon.2011.04.021.
Uterine leiomyosarcomas (LMS) rarely are suspected preoperatively unless there has been documented rapid growth of the uterus or evidence of extrauterine disease. Thus, it is not surprising that the antecedent procedures performed for a number of these cases are uterine sparing, such as myomectomy, or uterine morcellation at the time of vaginal hysterectomy or under endoscopic guidance. The impact of these procedures on patterns of recurrence and survival was addressed in a retrospective evaluation of a referral population over an 11-year period. In all, researchers identified 77 patients, from which 56 were considered "early stage,"...