Clinical outcome affected by tumor morcellation in unexpected early uterine leiomyosarcoma

Lin, Kuan‐Hung; Torng, Pao-Ling; Tsai, Ko-Hsin; Shih, Ho-Jun; Chen, Chi‐Ling

doi:10.1016/j.tjog.2015.03.001

Cited by 11 publications

(7 citation statements)

References 30 publications

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“…Notably, in two cases, we observed dissemination of sarcoma after morcellation on both sides of the abdominal wall, in the area of trocar placement at the first operation. In contrast, Lin et al ( 24 ) reported that morcellation of sarcoma did not increase the abdominal pelvic recurrence rate, but may be associated with poorer survival in unexpected FIGO-stage-1 disease. Besides tumor morcellation, any type of tumor injury may aggravate hematogenous spread of tumor cells.…”

Section: Discussionmentioning

confidence: 88%

“…A higher tumor stage (FIGO IB) was also significantly associated with the outcome. In a study comprising 34 patients with early leiomyosarcoma, Lin et al evaluated the effect of morcellation on the outcome and concluded that the size of tumor outweighed morcellation; the former was more significant than morcellation in predicting a poor outcome (24). However, it should be noted that, in small studies, a slight difference in tumor size might cause a large difference in the combined statistical analysis of survival outcome.…”

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 99%

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Effect of tumor morcellation in patients with early uterine sarcoma: a multicenter study in Germany

Gitas¹,

Ertan²,

Baum³

et al. 2022

J Turkish German Gynecol Assoc

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The use of power morcellation at laparoscopy may worsen survival rates for patients with malignancy. The aim of the present study was to report the outcome of patients with early-stage uterine sarcoma after morcellation or total en-bloc resection, and evaluate potential signs of sarcoma preoperatively. Material and Methods: This multicenter retrospective study consisted of patients, who underwent surgery for FIGO-stage-I uterine sarcoma. Twenty-four patients were divided into a non-morcellation group and a morcellation group. Clinical records and the outcomes of patients, including one-, three-and five-year survival rates were reviewed. Preoperative characteristics of patients with sarcoma were compared to those of a control group with uterine myoma (1:4 ratio), matched by age and type of operation. Results: Obesity was an independent risk factor for uterine myoma. Tumor growth, solitary growth, largest-diameter lesion > 8.0 cm, and anechoic areas suggesting necrosis and increased vascularization were significantly more common in the sarcoma group. A large tumor diameter was significantly associated with mortality. Patients in the non-morcellation group had a slightly lower disease-free survival, but poorer overall survival rates compared to patients in the morcellation group, however both differences were not statistically significant. Patients in the nonmorcellation group, who had undergone a re-exploration experienced late recurrence, but we registered no upstaging after the operation. Conclusion: Preoperative ultrasound characteristics could be useful to distinguish sarcoma from leiomyoma of uterus. Morcellation of a sarcoma may increase abdominal and pelvic recurrence rates, but may not be associated with overall survival in patients with FIGO stage I disease.

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Section: Discussionmentioning

confidence: 88%

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 99%

Effect of tumor morcellation in patients with early uterine sarcoma: a multicenter study in Germany

Gitas¹,

Ertan²,

Baum³

et al. 2022

J Turkish German Gynecol Assoc

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“…Clínicamente los leiomiosarcomas se manifiestan con signos y síntomas inespecíficos, como son el incremento del tamaño uterino, sangrado vaginal anormal y dolor abdominal (12) . Debido a esto, suelen ser diagnosticados de forma incidental o cuando se encuentran en un estadio avanzado de la enfermedad.…”

Section: Discussionunclassified

Leiomiosarcoma asociado a embarazo

Aguedo

Guerrero

Polanco

2018

Rev peru ginecol obstet.

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Los leiomiosarcomas uterinos son tumores malignos poco frecuentes que generalmente se presentan con síntomas inespecíficos, por lo que su diagnóstico suele ser incidental. Los casos más frecuentes se presentan en mujeres posmenopáusicas a quienes se les interviene quirúrgicamente por leiomiomas. La asociación de los leiomiosarcomas uterinos con la gestación es rara; solo existen doce casos reportados hasta la actualidad. Se presenta un caso de leiomiosarcoma uterino en una paciente gestante a quien se le realizó histerectomía por atonía uterina.

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“…In addition, no standardized therapeutic regimen has been available for uLMS due to its rare occurrence and rapid progression (6,7), effective and standardized therapy is urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Curdione Induces Antiproliferation Effect on Human Uterine Leiomyosarcoma via Targeting IDO1

Wei

et al. 2021

Front. Oncol.

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ObjectivesCurdione is one of the active ingredients of a traditional Chinese herbal medicine-Curcuma zedoary and established anti-tumor effects. Uterine leiomyosarcoma (uLMS) is a rare gynecological malignancy, with no standard therapeutic regimen at present. The aim of this study was to explore the potential anti-tumor impact of curdione in uLMS and elucidate the underlying mechanisms.MethodsIn vitro functional assays were performed in the SK-UT-1 and SK-LMS-1 cell lines. The in vivo model of uLMS was established by subcutaneously injecting SK-UT-1 cells, and the tumor-bearing mice were intraperitoneally injected with curdione. Tumor weight and volume were measured at specific time points. The biosafety was evaluated by monitoring changes of body weight and the histopathology in the liver and kidney. The expression levels of relevant proteins were analyzed by western blotting and immunohistochemistry.ResultsCurdione decreased the viability and proliferation of uLMS cells in a concentration and time-dependent manner. In addition, the curdione-treated cells exhibited significantly higher rates of apoptosis and autophagic death. Curdione also decreased the tumor weight and volume in the SK-UT-1 xenograft model compared to the untreated control without affecting the body bodyweight or pathological injury of liver and kidney tissues. At the molecular level, the anti-tumor effects of curdione were mediated by indoleamine-2, 3-dioxygenase-1 (IDO1).ConclusionCurdione exhibited an anti-uLMS effect in vitro and in vivo; the underlying mechanism involved in IDO1 mediate apoptosis, autophagy, and G2/M phase arrest.

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Clinical outcome affected by tumor morcellation in unexpected early uterine leiomyosarcoma

Abstract: Tumor morcellation did not increase the abdominal-pelvic recurrence rate, but may be associated with lower DFS and OS in Stage 1 LMS.

Cited by 11 publications

References 30 publications

Effect of tumor morcellation in patients with early uterine sarcoma: a multicenter study in Germany

Effect of tumor morcellation in patients with early uterine sarcoma: a multicenter study in Germany

Leiomiosarcoma asociado a embarazo

Curdione Induces Antiproliferation Effect on Human Uterine Leiomyosarcoma via Targeting IDO1

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