Abstract
Study Objective: To determine the incidence and impact of occult uterine malignancy following vaginal hysterectomy and uncontained morcellation. Design: An Institutional Review Board-approved retrospective cohort study (Canadian Task Force classification II-2). Setting: Three academic medical centers. Patients: All women who underwent vaginal hysterectomy between January 1, 2008, and August 31, 2015, at 3 institutions were considered for inclusion in the study. Interventions: Total vaginal hysterectomy with and without morcellation. Measurements and Main Results: A total of 2296 women underwent total vaginal hysterectomy without (n = 1685) or with (n = 611) vaginal morcellation performed via cold-knife wedge resection. All patients requiring morcellation had benign indications for hysterectomy. The incidence of occult uterine malignancy among hysterectomies requiring vaginal morcellation was 0.82% (n = 5) and included stage IA, grade I endometrial adenocarcinoma (n = 3; 0.49%) and low grade stromal sarcoma (n = 2; 0.33%). Demographic data for those with occult malignancy included mean age 48.8 years, mean body mass index 32.36 kg/m2, and median parity 2. Indication for hysterectomy was abnormal uterine bleeding for the 5 patients who underwent morcellation and were found to have a malignancy. Final pathology revealed a mean uterine weight of 231.60 g. All patients have remained disease-free, and no deaths have occurred. Mean disease-free survival was 48.33 months (range, 33-67 months) for the patients with endometrial adenocarcinoma and 42.0 months (range, 19-65 months) for the patients with stromal sarcoma for the 5 patients who underwent vaginal hysterectomy with morcellation. Conclusion: Among patients undergoing vaginal hysterectomy with morcellation, the incidence of occult uterine carcinoma is 0.82%. Uncontained vaginal morcellation when used concomitantly with vaginal hysterectomy does not appear to negatively impact patient prognosis or outcomes.
| Original language | English (US) |
|---|---|
| Journal | Journal of Minimally Invasive Gynecology |
| DOIs | |
| State | Accepted/In press - Nov 29 2016 |
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Keywords
- Cancer
- Morcellate
- Uterus
ASJC Scopus subject areas
- Obstetrics and Gynecology
Cite this
Incidence of Occult Uterine Malignancy Following Vaginal Hysterectomy With Morcellation. / Wasson, Megan; Magtibay, Paul; Magtibay, Paul; Magrina, Javier.
In: Journal of Minimally Invasive Gynecology, 29.11.2016.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Incidence of Occult Uterine Malignancy Following Vaginal Hysterectomy With Morcellation
AU - Wasson, Megan
AU - Magtibay, Paul
AU - Magtibay, Paul
AU - Magrina, Javier
PY - 2016/11/29
Y1 - 2016/11/29
N2 - Study Objective: To determine the incidence and impact of occult uterine malignancy following vaginal hysterectomy and uncontained morcellation. Design: An Institutional Review Board-approved retrospective cohort study (Canadian Task Force classification II-2). Setting: Three academic medical centers. Patients: All women who underwent vaginal hysterectomy between January 1, 2008, and August 31, 2015, at 3 institutions were considered for inclusion in the study. Interventions: Total vaginal hysterectomy with and without morcellation. Measurements and Main Results: A total of 2296 women underwent total vaginal hysterectomy without (n = 1685) or with (n = 611) vaginal morcellation performed via cold-knife wedge resection. All patients requiring morcellation had benign indications for hysterectomy. The incidence of occult uterine malignancy among hysterectomies requiring vaginal morcellation was 0.82% (n = 5) and included stage IA, grade I endometrial adenocarcinoma (n = 3; 0.49%) and low grade stromal sarcoma (n = 2; 0.33%). Demographic data for those with occult malignancy included mean age 48.8 years, mean body mass index 32.36 kg/m2, and median parity 2. Indication for hysterectomy was abnormal uterine bleeding for the 5 patients who underwent morcellation and were found to have a malignancy. Final pathology revealed a mean uterine weight of 231.60 g. All patients have remained disease-free, and no deaths have occurred. Mean disease-free survival was 48.33 months (range, 33-67 months) for the patients with endometrial adenocarcinoma and 42.0 months (range, 19-65 months) for the patients with stromal sarcoma for the 5 patients who underwent vaginal hysterectomy with morcellation. Conclusion: Among patients undergoing vaginal hysterectomy with morcellation, the incidence of occult uterine carcinoma is 0.82%. Uncontained vaginal morcellation when used concomitantly with vaginal hysterectomy does not appear to negatively impact patient prognosis or outcomes.
AB - Study Objective: To determine the incidence and impact of occult uterine malignancy following vaginal hysterectomy and uncontained morcellation. Design: An Institutional Review Board-approved retrospective cohort study (Canadian Task Force classification II-2). Setting: Three academic medical centers. Patients: All women who underwent vaginal hysterectomy between January 1, 2008, and August 31, 2015, at 3 institutions were considered for inclusion in the study. Interventions: Total vaginal hysterectomy with and without morcellation. Measurements and Main Results: A total of 2296 women underwent total vaginal hysterectomy without (n = 1685) or with (n = 611) vaginal morcellation performed via cold-knife wedge resection. All patients requiring morcellation had benign indications for hysterectomy. The incidence of occult uterine malignancy among hysterectomies requiring vaginal morcellation was 0.82% (n = 5) and included stage IA, grade I endometrial adenocarcinoma (n = 3; 0.49%) and low grade stromal sarcoma (n = 2; 0.33%). Demographic data for those with occult malignancy included mean age 48.8 years, mean body mass index 32.36 kg/m2, and median parity 2. Indication for hysterectomy was abnormal uterine bleeding for the 5 patients who underwent morcellation and were found to have a malignancy. Final pathology revealed a mean uterine weight of 231.60 g. All patients have remained disease-free, and no deaths have occurred. Mean disease-free survival was 48.33 months (range, 33-67 months) for the patients with endometrial adenocarcinoma and 42.0 months (range, 19-65 months) for the patients with stromal sarcoma for the 5 patients who underwent vaginal hysterectomy with morcellation. Conclusion: Among patients undergoing vaginal hysterectomy with morcellation, the incidence of occult uterine carcinoma is 0.82%. Uncontained vaginal morcellation when used concomitantly with vaginal hysterectomy does not appear to negatively impact patient prognosis or outcomes.
KW - Cancer
KW - Morcellate
KW - Uterus
UR - http://www.scopus.com/inward/record.url?scp=85016476583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016476583&partnerID=8YFLogxK
U2 - 10.1016/j.jmig.2017.01.025
DO - 10.1016/j.jmig.2017.01.025
M3 - Article
C2 - 28254678
AN - SCOPUS:85016476583
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
SN - 1553-4650
ER -