Intrapelvic dissemination of early low-grade endometrioid stromal sarcoma due to electronic morcellation

Choo, Kyoung-Ja; Lee, Hyun Joo; Lee, Tae Sung; Kim, Ju Hyun; Koh, Suk Bong; Choi, Youn Seok

doi:10.5468/ogs.2015.58.5.414

Cited by 7 publications

(4 citation statements)

References 11 publications

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“…The risk of tumor is higher when an electric morcellator is used than in other laparoscopic procedures; however, the precise relative risk is not known [ 18 ]. It has been reported that the progression of disease was sped up in about 30% of the 53 unexpectedly discovered sarcomas discovered in 17,903 women undergoing surgery for fibroids and that 1/1000 morcellations will contribute to a poor prognosis [ 19 ]. Hinchcliff et al have shown that the use of a morcellator increases the risk of abdominal/pelvic recurrence in patients ( P = 0.001) and shortens the median tumor-free survival time (10.8 vs. 39.6 months; P = 0.002) but does not affect the overall survival [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations and prognosis of unexpected uterine sarcoma of uterine fibroids in Tianjin China

Cheng

Gong

2022

BMC Women's Health

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Background Uterine sarcoma is a rare malignancy of women and fewer uterine sarcomas are detected preoperatively. The reported incidence of preoperatively diagnosed uterine sarcoma (PDUS) was 0.07%. This study aims to identify the prevalence of unexpected uterine sarcoma (UUS) after operation for presumed leiomyoma and compare clinical outcomes after primary therapy. Methods A retrospective study was performed evaluating all uterine sarcoma diagnosed in Tianjin Central Hospital of Gynecology and Obstetrics between May 2011 and July 2016.We used the χ2 and T tests to assess the incidence and clinical features of patients. The Kaplan–Meier method was used to calculate disease-related survival. Results The study retrospectively analyzed 6625 patients with uterine fibroids and found 45 UUS patients and 21 patients of PDUS. The incidence of UUS is (45/6625) 0.67%. The incidence of UUS in patients undergoing total hysterectomy was higher undergoing tumor resection (P < 0.001); the age of UUS is younger than PDUS (P = 0.046); the differences in menopausal status and primary complaints between the two groups are not statistically significant. The PDUS group had more patients with Stage II and III sarcomas than the UUS group (P < 0.001); the duration of symptoms in the PDUS group was longer than in the UUS group (P = 0.033). The 5-year overall survival (OS) rate of the UUS group (77.7%) is higher than the PDUS group (46.3%) (P < 0.001). Conclusions The incidence of UUS is low. UUS has a younger age of onset, shorter history of the disease, earlier clinical stage, and better prognosis.

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Section: Discussionmentioning

confidence: 99%

Clinical manifestations and prognosis of unexpected uterine sarcoma of uterine fibroids in Tianjin China

Cheng

Gong

2022

BMC Women's Health

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“…The risk of tumor is higher when an electric morcellator is used than in other laparoscopic procedures; however, the precise relative risk is not known [10]. It has been reported that progression of disease was sped up in about 30% of the 53 unexpectedly discovered sarcomas discovered in 17,903 women undergoing surgery for broids and that 1/1000 morcellations will contribute to a poor prognosis [11]. Hinchcliff [12] et al have shown that the use of a morcellator increases the risk of abdominal/pelvic recurrence of patients (P = 0.001) and shortens the median tumor-free survival time (10.8 vs. 39.6 months; P = 0.002) but does not affect the overall survival.…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations and Prognosis of Unexpected Uterine Sarcoma

Cheng

Gong

2022

Preprint

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Background To investigate the clinical manifestations and treatment of unexpected uterine sarcoma (UUS) and thus to improve the preoperative diagnostic rate and to reduce the risk of unexpected tumor dissemination. Methods The study retrospectively analyzed 45 UUS patients and 21 patients of preoperatively diagnosed uterine sarcoma (PDUS). We used the χ2 and T tests to assess the incidence and clinical features of patients. The Kaplan-Meier method was used to calculated disease related survival. Results The incidence of UUS is (45/6625) 0.67%.The incidence of UUS in patients undergoing total hysterectomy was higher than that in patients undergoing tumor resection (P < 0.001); The age of UUS is younger than that of PDUS (P = 0.046); The differences in menopausal status and primary complaints between the two groups are not statistically significant (P > 0.05).PDUS group had more patients with Stage II and III sarcomas than that of UUS group(P < 0.001); Duration of symptoms in PDUS group was longer than that of UUS group( P = 0.033). The 5-year overall survival(OS) rate of UUS group(77.7%) is higher than that of PDUS group(46.3% ) (P < 0.001). Conclusions The incidence of UUS is low. UUS has younger age of onset, shorter history of disease, earlier clinical stage, and better prognosis.

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“…Moreover, laparoscopy was often used in the first operation. Choo suggested that intrapelvic dissemination was due to electronic morcellation [9]. A consensus review suggested morcellation should be avoided [10].…”

Section: Discussionmentioning

confidence: 99%

Article Evaluation of treatment strategies and prognostic factors of 135 patients with low-grade endometrial stromal sarcoma

Wang

Liang

Zhang

et al. 2019

Preprint

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Background: To evaluate the influence of treatment modalities and prognostic factors on the survival of patients with low-grade endometrial stromal sarcoma (LGESS). Methods: One hundred and thirty-five LGESS patients in Fudan University Shanghai Cancer Center from January 2006 to December 2018 were retrospectively reviewed. Results: Two patients received fertility-sparing surgery while 133 patients received hysterectomy. The median follow-up duration was 52 months (3–342 months). One hundred and nine (80.7%) patients received ovariectomy, 73 (54.1%) patients had lymphadenectomy, 83 (61.5%) patients received adjuvant therapy. The 5-year and 10-year disease free survival rates were 72.0% and 61.0%, respectively. The 5-year and 10-year overall survival rates were 88.0% and 79.8%, respectively. Surgery for recurrence was associated with improved overall survival although the complication rate was about 27.6%. Multivariate analysis showed that lymphovascular invasion was associated with disease free survival (hazard ratio, 0.473; 95 % confidence interval, 0.235–0.952; p=0.036) and menopausal status was related to overall survival (hazard ratio, 5.561; 95 % confidence interval, 1.400–22.084; p=0.015). Conclusions: There was no effect of lymphadenectomy, ovariectomy, or adjuvant therapy on patients’ recurrence and survival. Hysterectomy may be proposed as the standard treatment for LGESS. Surgery for replase was an acceptable method to improve overall survival. Lymphovascular invasion was a significant independent factor for disease free survival. Postmenopause was the poor prognostic factor for overall survival.

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Intrapelvic dissemination of early low-grade endometrioid stromal sarcoma due to electronic morcellation

Cited by 7 publications

References 11 publications

Clinical manifestations and prognosis of unexpected uterine sarcoma of uterine fibroids in Tianjin China

Clinical manifestations and prognosis of unexpected uterine sarcoma of uterine fibroids in Tianjin China

Clinical Manifestations and Prognosis of Unexpected Uterine Sarcoma

Article Evaluation of treatment strategies and prognostic factors of 135 patients with low-grade endometrial stromal sarcoma

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