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ORIGINAL ARTICLE
Year : 2017  |  Volume : 130  |  Issue : 22  |  Page : 2661-2665

Proportion of Uterine Malignant Tumors in Patients with Laparoscopic Myomectomy: A National Multicenter Study in China


1 Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730, China
2 Department of Biostatistics, Peking University Clinical Research Institute, Peking University First Hospital, Beijing 100871, China
3 Department of Obstetrics and Gynecology, Zhejiang University Affiliated Obstetrics and Gynecology Hospital, Zhejiang, Hangzhou 310006, China
4 Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, Sichuan 610041, China
5 Department of Obstetrics and Gynecology, The First People's Hospital of Foshan City, Foshan, Guangdong 528010, China
6 Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Henan Province, Zhengzhou, Henan 450052, China
7 Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Datong, Shanxi 030001, China
8 Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang 830000, China
9 Department of Obstetrics and Gynecology, People's Hospital of Fujian Province, Fuzhou, Fujian 350000, China
10 Department of Obstetrics and Gynecology, Qinghai Red Cross Hospital, Xining, Qinghai 810000, China
11 Department of Obstetrics and Gynecology, Dalian Maternity Hospital, Dalian, Liaoning 116021, China
12 Department of Obstetrics and Gynecology, Tianjin Central Maternity Hospital, Tianjin 300100, China
13 Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
14 Department of Obstetrics and Gynecology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750003, China
15 Department of Obstetrics and Gynecology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150007, China
16 Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, Jilin 130041, China
17 Department of Obstetrics and Gynecology, Shanghai Tongji Hospital, Shanghai 200065, China
18 Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
19 Department of Obstetrics and Gynecology, Qingdao Municipal Hospital, Qingdao, Shandong 266011, China
20 Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Nanjing, Nanjing, Jiangsu 210004, China
21 Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Guiyang City, Guiyang, Guizhou 550001, China
22 Department of Obstetrics and Gynecology, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
23 Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Gansu Province, Lanzhou, Gansu 730050, China
24 Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Anhui Province, Hefei, Anhui 230011, China
25 Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050073, China
26 Department of Obstetrics and Gynecology, Hainan Provincial People's Hospital, Haikou, Hainan 570311, China
27 Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Jiangxi Province, Nanchang, Jiangxi 330006, China
28 Department of Obstetrics and Gynecology, The Second Hospital Affiliated to Chongqing Medical University, Chongqing 400010, China
29 Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, China
30 Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
31 Department of Obstetrics and Gynecology, Affiliated Hospital of Inner Mongolia Medical College, Hohhot, Inner Mongolia Autonomous Region 010050, China

Correspondence Address:
Lan Zhu
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.218008

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Background: The Food and Drug Administration recently announced that the use of morcellation may cause fibroids or pelvic dissemination and metastasis of uterine sarcoma; therefore, the use of morcellation is limited in the USA. A large sample study is necessary to assess the proportion of uterine malignant tumors found in patients with laparoscopic myomectomy. Methods: A national multicenter study was performed in China. From 2002 to 2014, 33,723 cases were retrospectively selected. We calculated the prevalence and recorded the clinical characteristics of the patients with malignancy after morcellation application. A total of 62 cases were finally pathologically confirmed as malignant postoperatively. Additionally, the medical records of the 62 patients were analyzed in details. Results: The proportion of postoperative malignancy after morcellation application was 0.18% (62/33,723) for patients who underwent laparoscopic myomectomy. Nearly 62.9% (39/62) of patients had demonstrated blood flow signals in the uterine fibroids before surgery. And, 23 (37.1%) patients showed rapid growth at the final preoperative ultrasound. With respect to the pathological types, 38 (61.3%) patients had detectable endometrial stromal sarcoma, 13 (21.0%) had detectable uterine leiomyosarcoma, only 3 (3.2%) had detectable carcinosarcoma, and 5 (8.1%) patients with leiomyoma had an undetermined malignant potential. Conclusions: The proportion of malignancy is low after using morcellation in patients who undergo laparoscopic myomectomy. Patients with fast-growing uterine fibroids and abnormal ultrasonic tumor blood flow should be considered for malignant potential, and morcellation should be avoided.


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