Retrospective cohort study evaluating the impact of intraperitoneal morcellation on outcomes of localized uterine leiomyosarcoma.

摘要: BACKGROUND Uterine leiomyosarcoma (ULMS) is identified in 0.1% to 0.2% of hysterectomy specimens presumed leiomyoma. To date, there no preoperative technique that reliably differentiates ULMS from uterine Increasing use minimally invasive approaches for the management leiomyomas may result inadvertently morcellated with resultant intraperitoneal dissemination tumor. The objective this study was assess impact morcellation on outcomes patients ULMS. METHODS In retrospective cohort study, all who attended authors' institutions 2007 2012 were reviewed. Demographics and compared between those underwent or total abdominal (TAH) as their first surgery uterus-limited ULMS. RESULTS In total, 58 identified, including 39 TAH 19 morcellation. Intraperitoneal associated a significantly increased risk abdominal/pelvic recurrences (P = .001) shorter median recurrence-free survival (10.8 months vs 39.6 months; P = .002). A multivariate adjusted model demonstrated >3 times recurrence (hazard ratio, 3.18; 95% confidence interval, 1.5-6.8; P = .003). CONCLUSIONS Intraperitoneal leiomyoma worsens women ULMS. Because are reliable techniques distinguish benign leiomyoma, efforts minimize should be considered. [See editorial pages 000-000, issue.] Cancer 2014;120:3154–3158. © 2014 American Society.