当前位置： SCI文献检索 > Journal of Minimally Invasive Gynecology期刊下所有文献 > Impact of Surgery on the Evolution of Uterine Sarcomas.

Impact of Surgery on the Evolution of Uterine Sarcomas.

Abstract：

STUDY OBJECTIVE:To identify the characteristics of uterine sarcomas and assess the impact of morcellation on prognosis. DESIGN:Case-control study. (Canadian Task Force classification II-2). SETTING:Hospital Quiron-Dexeus, an academic hospital. PATIENTS:Patients with uterine sarcoma histologically diagnosed and treated in our center between 1987 and 2013. INTERVENTION:All descriptive data, including type of surgery and clinical and pathological data, were reviewed. Survival analysis was performed comparing patients with hysterectomy/myomectomy without any type of morcellation and patients with morcellation during surgery. MEASUREMENTS AND MAIN RESULTS:A total of 37 sarcomas were diagnosed during the study period. The most common symptom was metrorrhagia (50%). The indication for surgery was related to myoma growth in 40% of cases and to metrorrhagia in 37.1% of cases. Open surgery was performed in 23 patients (62.2%), and laparoscopy was performed in 9 (24.3%). Myomectomy was performed in 14 patients (37.8%), and 23 patients (62.1%) underwent hysterectomy as initial surgery. Morcellation for tumor extraction was done in 8 cases (21.6%). Survival analysis by surgical approach showed increased disease-free survival (DFS) in the laparotomy group compared with the laparoscopy group (median, 70.3 months vs 10.4 months; p = .018). Median DFS according to type of surgery was 6.3 months in morcellation cases, 11.9 months in vaginal fragmentation cases, and 149.9 months in nonmorcellated cases (p < .002). The median time to progression was shorter in morcellated cases (laparocopic and vaginal) compared with nonmorcellated cases (11.9 vs 14.9 months; p < .001). No statistically significant differences in prognosis were related to myomectomy versus hysterectomy; however, there were significants difference between morcellation and nonmorcellation cases. CONCLUSION:Taking into account the negative impact of morcellation in sarcomas, the use of this technique should be reconsidered in cases of myoma with atypical clinical presentation or symptomatology. Patients must be informed about the possibility of a nonidentified sarcoma and the possible impact on prognosis resulting from its morcellation.

journal_name

J Minim Invasive Gynecol

journal_title

Journal of minimally invasive gynecology

authors

Cusidó M,Fargas F,Baulies S,Plana A,Rodríguez I,Tresserra F,Pascual MA,Fábregas R

doi

10.1016/j.jmig.2015.05.024

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

1068-74

issue

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(15)00424-0

journal_volume

pub_type

杂志文章

在线工具

Impact of Surgery on the Evolution of Uterine Sarcomas.