Laparoscopic Supracervical Hysterectomy or Myomectomy With Power Morcellation: Risk of Uterine Leiomyosarcomas. A Retrospective Trial Including 35.161 Women in Germany

Nugent, W.; Engelke, G; Reicke, S; Soder, Ricardo Bernardi; Hennefründ, J; Hasskamp, Thomas; Bung, P.; Weisbach, W; Köhler, Günter

doi:10.1016/j.jmig.2015.08.013

Cited by 10 publications

(6 citation statements)

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“…These numbers are in concurrence with the studies found in our literature search. In total, 7 multicenter cohorts were found with incidences ranging from 2.3% or 1:44 to 0.07% or 1:1465 cases [12–18] (Table 3). Unfortunately, a meta-analysis of the data from these studies could not be performed due to heterogeneity of the included study population.…”

Section: Discussionmentioning

confidence: 99%

Incidence and groups at risk for unexpected uterine leiomyosarcoma: a Dutch nationwide cohort study

Haak

Kroon

Warmerdam

et al. 2018

Arch Gynecol Obstet

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ObjectiveTo estimate the risk of uterine leiomyosarcoma in patients undergoing gynecological surgery and also to identify groups at risk for unrecognized uterine leiomyosarcoma.MethodsA national cohort study was performed evaluating all uterine leiomyosarcoma (ULMS) diagnosed in The Netherlands between January 2000 and September 2015. Cases were identified and supplied by the nationwide network and registry of histo- and cytopathology in The Netherlands (PALGA). Unexpected and expected ULMS were compared. Approval for this study was granted by the Medical Ethics Committee of all participating hospitals and by the review board of PALGA.Results262 original cases were included. The overall incidence of ULMS in our study was 0.25% or 1:400 patients. The incidence of unexpected ULMS was 0.12% or 1:865 patients. Preoperatively, a malignancy was unexpected in 46% of the cases and expected in 54%. Abnormal uterine bleeding constituted most of the symptoms. 90% of women underwent abdominal hysterectomy and/or bilateral salpingo-oophorectomy.ConclusionsLeiomyosarcoma are rare. Women aged 40–50 years with abnormal uterine bleeding are most at risk for unexpected ULMS. In contrast, this risk is low in postmenopausal women. ULMS were highly uncommon in women aged under 40 years.

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Section: Discussionmentioning

confidence: 99%

Incidence and groups at risk for unexpected uterine leiomyosarcoma: a Dutch nationwide cohort study

Haak

Kroon

Warmerdam

et al. 2018

Arch Gynecol Obstet

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“…[ 15 , 26 – 28 ] Previous studies have reported that using LPM in myomectomy or hysterectomy operations can increase the risk of spreading unsuspected cancer within the abdomen and pelvis. [ 15 , 26 – 28 ] The CO 2 gas in the abdomen would be discharged through the port-site, which provides an opportunity for tumor fragments to accumulate at the port-site; this is also the reason why our 2 cases of relapsed tumors were found at the port-site. Consequently, LPM should be used in combination with compatible containment systems to treat ovarian AGCT.…”

Section: Discussionmentioning

confidence: 99%

Disseminated ovarian granulosa cell tumor after laparoscopic surgery

et al. 2021

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Rationale: Granulosa cell tumors (GCT) have an incidence of 0.6 to 0.8/100,000. Short-term relapsed ovarian GCT is extremely rare. Herein, this report aims to present 2 rare cases of disseminated ovarian GCT and analyze the causes of recurrence. Patient concerns: The 2 patients presented with abdominal pain. Diagnosis: Both the patients were diagnosed with relapsed ovarian GCT (IIIc stage) in the adult type. Interventions: The 2 patients had a medical history of surgery for ovarian GCT by using laparoscopic with power morcellators (LPM). They experienced relapsed ovarian GCT postoperatively. Subsequently, they received a repeated operation through a laparotomy approach. Numerous malignant metastasis neoplasms were detected at the port-sites. Then, tumor resection was performed. Outcomes: The postoperative pathologies of both case 1 and case 2 reported ovarian GCT (IIIc stage) in adult type. The 2 patients presented disease-free survival for more than 33 months follow-up period. Lessons: The application of LPM may be a risk factor of disseminated ovarian GCT. However, laparoscopic surgery is still an optimal treatment strategy for ovarian tumors. Besides, gynecologists should comply with the tumor-free principle during surgery.

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“…A few other reports focused on LSH were published (Tab. 8) [19][20][21][22][23][24][25][26][27][28]. Some studies have focused only on the incidence of occult leiomyosarcoma, because other malignancies, eg.…”

Section: Discussionmentioning

confidence: 99%