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.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jmig.2015.05.024 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Implant failure of the Compress prosthesis: a case report.
J Med Case Rep
January 2025
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
Background: The Compress is designed to achieve bone formation and stability by applying pressure at the bone-implant interface, minimizing the likelihood of aseptic loosening, which is a complication of stem implants. Herein, we report two cases of implant failure using the Compress.
Case Presentation: Case 1 describes a 36 year-old Japanese man who underwent extraarticular tumor resection, Compress arthroplasty, and reconstruction with a gastrocnemius flap after preoperative chemotherapy for a secondary malignant giant cell tumor in the right distal femur.
A combined school survey and reactive case detection reveals minimal local transmission of malaria in the Highlands Region of Papua New Guinea.
Malar J
January 2025
Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
Background: The Highlands of Papua New Guinea are non-endemic for malaria compared to the rest of the country. This study aimed to explore the local transmission of malaria in the Highlands through a cross-sectional school survey coupled with reactive case detection.
Methods: Between July and November 2019, 5575 schoolchildren and 1048 household members were screened for malaria using Rapid Diagnostic Tests, subsequently validated by light microscopy.
Potentially actionable molecular alterations in particular related to poor oncologic outcomes in salivary gland carcinomas.
BMC Cancer
January 2025
Department of Tumor Biology and Genetics, Medical University of Warsaw, Warsaw, Poland.
Aim: The study was designed to evaluate molecular alterations, relevant to the prognosis and personalized therapy of salivary gland cancers (SGCs).
Materials And Methods: DNA was extracted from archival tissue of 40 patients with various SGCs subtypes. A targeted next-generation sequencing (NGS) panel was used for the identification of small-scale mutations, focal and chromosomal arm-level copy number changes.
Global, regional, and national incidence and mortality for enteric infections from 1990 to 2019.
BMC Public Health
January 2025
Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China.
Background: Enteric infections are among the most common infectious diseases. The aim of this article was to track the global trends in morbidity and mortality from enteric infections in 204 countries or territories from 1990 to 2019.
Methods: Data were obtained from the Global Burden of Disease 2019 study.
Development of a pandemic-related core set of quality indicators for quality and patient safety in University Hospitals in Germany.
BMC Health Serv Res
January 2025
Institute for Health Services Research and Clinical Epidemiology, Faculty of Medicine, Philipps-University Marburg, Marburg, Germany.
Background: The COVID-19 pandemic entailed a global health crisis, significantly affecting medical service delivery in Germany as well as elsewhere. While intensive care capacities were overloaded by COVID cases, not only elective cases but also non-COVID cases requiring urgent treatment unexpectedly decreased, potentially leading to a deterioration in health outcomes. However, these developments were only uncovered retrospectively.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!