Key clinical point: Morcellation during hysterectomy in patients with incidental uterine sarcoma may cause impaired survival. Among Norwegian women with undiagnosed uterine sarcomas, the 10-year age-adjusted survival after morcellation was 32.2% compared with 57.2% without morcellation, yielding an age-adjusted hazard ratio of 1.9.
Major finding: The risk of dying from uterine sarcoma after morcellation was 1.5 per 1000 procedures. Sarcoma mortality was higher among women who underwent morcellation (age-adjusted HR 1.90, CI 1.05–3.44; multivariate HR, 2.50, 95% CI 0.57–10.9). Age-adjusted 10-year uterine sarcoma survival was 32.2% for women treated with morcellation compared with 57.2% for those who did not undergo morcellation (difference 25.5%; CI −55.7 to 18.1). All-cause 10-year survival was 32.2% in the morcellated group and 44.1% in the non-morcellated group (difference 11.9%; CI −40.9 to 32.7).
Study details: A study of 653 patients with uterine sarcoma diagnosed after 1991 when vaginal and laparoscopic hysterectomies were introduced in Norway; 23 (3.5%) of them underwent morcellation. Uterine sarcoma prevalence was 3.6 per 1000 laparoscopic hysterectomies.
Disclosures: The authors disclosed no financial conflicts.
Source: Bretthauer M et al. European Journal of Cancer; 2018, 62-68 https://doi.org/10.1016/j.ejca.2018.06.007
Bretthauer M et al. European Journal of Cancer; 2018, 62-68 https://doi.org/10.1016/j.ejca.2018.06.007
This Week's Must Reads
Opioid Prescribing After Cesarean Delivery, Obstet Gynecol; ePub 2018 Aug 4; Prabhu, et al
Low-Dose Aspirin Use During Pregnancy, Obstet Gynecol; ePub 2018 Jul; ACOG, SMFM
Postpartum Pain & Fatigue Management , Obstet Gynecol; ePub 2018 Jul; ACOG
Vaginal Preparation Before Cesarean Section, Cochrane Library; ePub 2018 Jul 17; Haas, et al
Maternal Outcomes by Race in Women Aged ≥40 Years, Obstet Gynecol; ePub 2018 Jul 10; Booker, et al
Must Reads in Gynecologic Cancer
Morcellation of incidental uterine sarcomas doubled 10-year mortality risk in Norwegian study, Bretthauer M et al. European Journal of Cancer; 2018, 62-68 https://doi.org/10.1016/j.ejca.2018.06.007
Place of Death in Patients with Gynecologic Cancer, Obstet Gynecol; ePub 2018 May 7; Hicks-Courant, et al
Recent IUD Use and Risk of Cervical Cancer, Contraception; ePub 2018 Apr 16; Averbach, et al
Occult Gynecologic Cancer in Hysterectomy or Myomectomy, Obstet Gynecol; ePub 2018 Mar 8; Desai, et al
Concomitant POPUI Procedures & Gynecologic Cancer Surgery, Female Pelvic Med Reconstr Surg; ePub 2018 Apr 4; Bochenska, et al