The impact of tumor morcellation during surgery on the prognosis of patients with apparently early uterine leiomyosarcoma

摘要: Abstract Objective. Uterine leiomyosarcoma (LMS) is usually diagnosed after surgery for leiomyoma; thus tumor morcellation frequently occurs. We evaluated the impact of during on prognosis patients with apparently early uterine LMS. Methods. Outcomes were retrospectively compared between who underwent total abdominal hysterectomy without and those that included abdominal, vaginal or laparoscopic morcellation. Results. assessed 56 consecutive stage I II LMS 1989 2010, 25 31 There no significant group differences in age, parity, menopausal status, body mass index, stage, mitotic count, grade, lymph node dissection, adjuvant therapy, follow-up duration. However, size was significantly smaller (9.8 cm vs. 7.3 cm, P = 0.022) ovarian tissue more preserved (38.7% 72%, P = 0.013) In univariate analysis, only associated poorer disease-free survival (DFS) (odds ratio [OR], 2.59; 95% confidence interval [CI], 1.03–6.50; P = 0.043), higher (I II; (OR, 19.12; CI, 1.19–307.11; P = 0.037)) 3.07; 1.05–8.93; P = 0.040) overall (OS). multivariate 20.34; 1.27–325.58; P = 0.033) 3.11; 1.07–9.06; P = 0.038) OS. The percentage abdomino–pelvic dissemination, as shown by peritoneal sarcomatosis apex recurrence, greater than (44% 12.9%, P = 0.032). Conclusion. Tumor increased rate dissemination adversely affected DFS OS