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The Impact of Tumor Morcellation During Surgery on the Outcomes of Patients with Apparently Early Low-Grade Endometrial Stromal Sarcoma of the Uterus

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to evaluate the impact of tumor morcellation on the outcomes of patients with apparently early low-grade endometrial stromal sarcoma (LGESS).

Methods

Outcomes were retrospectively compared between patients with apparently early LGESS who did not (group A, n = 27) or did (group B, n = 23) undergo tumor morcellation.

Results

There were no between-group differences in age, menopausal status, parity, body mass index, and preoperative presumptive diagnosis, nor were there between-group differences in tumor stage, tumor size, myometrial invasion, lymphovascular space invasion, frequency of ovarian preservation, adjuvant therapy, or follow-up time. More patients in group A underwent lymph node dissection (51.9 vs. 21.7%; P = 0.029). Only 1 patient in each group had distant recurrence. There were 2 patients (7.4%) in group A and 7 (31.4%) in group B who had abdominopelvic recurrence. The risk of abdominopelvic recurrence was significantly higher in group B than in group A (odds ratio [OR], 5.47; 95% confidence interval [95% CI], 1.04–29.70; P = 0.035). The 5-year disease-free survival (DFS) rates were 84% for group A and 55% for group B (P = 0.028) and the 5-year abdominopelvic DFS rates were 89 and 58% (P = 0.023), respectively. Multivariate analysis showed that tumor morcellation were significantly associated with poorer DFS (OR, 4.03; 95% CI, 1.06–15.30; P = 0.040) and abdominopelvic DFS (OR, 5.06; 95% CI, 1.02–25.04; P = 0.047).

Conclusions

Inadvertent tumor morcellation during surgery has an adverse impact on the outcomes of patients with early LGESS.

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Acknowledgement

This study was supported by a grant of the Korea Health technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A091279).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

    Jeong-Yeol Park MD, PhD, Dae-Yeon Kim MD, PhD, Jong-Hyeok Kim MD, PhD, Yong-Man Kim MD, PhD, Young-Tak Kim MD, PhD & Joo-Hyun Nam MD, PhD

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  1. Jeong-Yeol Park MD, PhD
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  2. Dae-Yeon Kim MD, PhD
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  3. Jong-Hyeok Kim MD, PhD
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  6. Joo-Hyun Nam MD, PhD
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Correspondence to Joo-Hyun Nam MD, PhD.

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Park, JY., Kim, DY., Kim, JH. et al. The Impact of Tumor Morcellation During Surgery on the Outcomes of Patients with Apparently Early Low-Grade Endometrial Stromal Sarcoma of the Uterus. Ann Surg Oncol 18, 3453–3461 (2011). https://doi.org/10.1245/s10434-011-1751-y

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  • DOI: https://doi.org/10.1245/s10434-011-1751-y

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