Effect of tumor morcellation during surgery in patients with early uterine leiomyosarcoma
Background: Uterine leiomyosarcomas (LMSs) are rare and aggressive but difficult to predict before surgery. Minimally invasive surgery using morcellation might cause tumor spreading during manipulating of tumor tissue. We aim to study the influence of morcellation on the prognosis of patients with e...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-08-01
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| Series: | Gynecology and Minimally Invasive Therapy |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213307015000568 |
| _version_ | 1818258352285679616 |
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| author | Kuan-Hung Lin Shih Ho-Jun Chi-Ling Chen Pao-Ling Torng |
| author_facet | Kuan-Hung Lin Shih Ho-Jun Chi-Ling Chen Pao-Ling Torng |
| author_sort | Kuan-Hung Lin |
| collection | DOAJ |
| description | Background: Uterine leiomyosarcomas (LMSs) are rare and aggressive but difficult to predict before surgery. Minimally invasive surgery using morcellation might cause tumor spreading during manipulating of tumor tissue. We aim to study the influence of morcellation on the prognosis of patients with early uterine LMS.
Methods: We retrospectively reviewed the medical records of all patients with stage 1 LMS treated between April 1993 and April 2014. Demographics and outcomes were compared between patients who underwent total hysterectomy without morcellation and those who underwent surgery with abdominal, vaginal, and laparoscopic morcellation.
Results: In total, 43 consecutive patients were identified, including 29 without morcellation and 14 with morcellation. Tumor size was significantly smaller (7.3 cm vs. 11.6 cm, p = 0.006) in patients with morcellation. Six (42.9%) patients with morcellation received reoperation at 18.5 days after the initial surgery. Patients with morcellation did not show higher recurrence rate, including the recurrence rate at the pelvic cavity, compared with patients without morcellation. Compared with patients without morcellation, Kaplan–Meier curves did not show significant difference in the disease-free survival (DFS) and overall survival (OS) in patients with morcellation. In univariate and multivariate analyses, tumor size was significantly associated with poor DFS and OS. Morcellation was not associated with survivals.
Conclusion: In patients with stage 1 LMS, survival is associated with tumor size. Morcellation does not seem to be associated with a worse prognosis in early stage LMS. |
| first_indexed | 2024-12-12T17:58:11Z |
| format | Article |
| id | doaj.art-5cb5d0d1ad9a4544a3839952a8ed84ae |
| institution | Directory Open Access Journal |
| issn | 2213-3070 |
| language | English |
| last_indexed | 2024-12-12T17:58:11Z |
| publishDate | 2015-08-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Gynecology and Minimally Invasive Therapy |
| spelling | doaj.art-5cb5d0d1ad9a4544a3839952a8ed84ae2022-12-22T00:16:40ZengWolters Kluwer Medknow PublicationsGynecology and Minimally Invasive Therapy2213-30702015-08-0143818610.1016/j.gmit.2015.01.010Effect of tumor morcellation during surgery in patients with early uterine leiomyosarcomaKuan-Hung Lin0Shih Ho-Jun1Chi-Ling Chen2Pao-Ling Torng3Department of Obstetrics and Gynecology, Hsinchu Cathay General Hospital, Hsinchu, TaiwanGraduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, TaiwanGraduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanBackground: Uterine leiomyosarcomas (LMSs) are rare and aggressive but difficult to predict before surgery. Minimally invasive surgery using morcellation might cause tumor spreading during manipulating of tumor tissue. We aim to study the influence of morcellation on the prognosis of patients with early uterine LMS. Methods: We retrospectively reviewed the medical records of all patients with stage 1 LMS treated between April 1993 and April 2014. Demographics and outcomes were compared between patients who underwent total hysterectomy without morcellation and those who underwent surgery with abdominal, vaginal, and laparoscopic morcellation. Results: In total, 43 consecutive patients were identified, including 29 without morcellation and 14 with morcellation. Tumor size was significantly smaller (7.3 cm vs. 11.6 cm, p = 0.006) in patients with morcellation. Six (42.9%) patients with morcellation received reoperation at 18.5 days after the initial surgery. Patients with morcellation did not show higher recurrence rate, including the recurrence rate at the pelvic cavity, compared with patients without morcellation. Compared with patients without morcellation, Kaplan–Meier curves did not show significant difference in the disease-free survival (DFS) and overall survival (OS) in patients with morcellation. In univariate and multivariate analyses, tumor size was significantly associated with poor DFS and OS. Morcellation was not associated with survivals. Conclusion: In patients with stage 1 LMS, survival is associated with tumor size. Morcellation does not seem to be associated with a worse prognosis in early stage LMS.http://www.sciencedirect.com/science/article/pii/S2213307015000568leiomyosarcomamorcellationprognosisstage 1 uterine LMS |
| spellingShingle | Kuan-Hung Lin Shih Ho-Jun Chi-Ling Chen Pao-Ling Torng Effect of tumor morcellation during surgery in patients with early uterine leiomyosarcoma Gynecology and Minimally Invasive Therapy leiomyosarcoma morcellation prognosis stage 1 uterine LMS |
| title | Effect of tumor morcellation during surgery in patients with early uterine leiomyosarcoma |
| title_full | Effect of tumor morcellation during surgery in patients with early uterine leiomyosarcoma |
| title_fullStr | Effect of tumor morcellation during surgery in patients with early uterine leiomyosarcoma |
| title_full_unstemmed | Effect of tumor morcellation during surgery in patients with early uterine leiomyosarcoma |
| title_short | Effect of tumor morcellation during surgery in patients with early uterine leiomyosarcoma |
| title_sort | effect of tumor morcellation during surgery in patients with early uterine leiomyosarcoma |
| topic | leiomyosarcoma morcellation prognosis stage 1 uterine LMS |
| url | http://www.sciencedirect.com/science/article/pii/S2213307015000568 |
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