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Outcomes of uterine sarcoma found incidentally after uterus-preserving surgery for presumed benign disease

 Jung-Yun Lee  ;  Hyun Soo Kim  ;  Eun Ji Nam  ;  Sang Wun Kim  ;  Sunghoon Kim  ;  Young Tae Kim 
 BMC CANCER, Vol.16(1) : 675, 2016 
Journal Title
Issue Date
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Hysterectomy/adverse effects* ; Laparoscopy ; Leiomyoma/pathology ; Leiomyoma/surgery* ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Sarcoma/epidemiology* ; Sarcoma/etiology ; Sarcoma/pathology ; Survival Rate ; Uterine Myomectomy/adverse effects* ; Uterine Neoplasms/pathology ; Uterine Neoplasms/surgery*
Endometrial stromal sarcoma ; Leiomyosarcoma ; Morcellation ; Myomectomy ; Survival analysis
BACKGROUND: The aims of this study were to evaluate the impact of initial uterus-preserving surgery, such as myomectomy or subtotal hysterectomy, on the recurrence rates of patients with uterine sarcoma found incidentally and to investigate the role of surgical re-exploration in this disease subset. METHODS: We performed a retrospective chart review for patients who had previously undergone either total hysterectomy or subtotal hysterectomy or myomectomy at the time of initial surgery for presumed benign uterine leiomyoma and were found to have uterine sarcoma on final pathology. Survival analysis was performed comparing patients according to the type of initial surgery. RESULTS: Between 2006 and 2014, 45 patients with uterine sarcoma were identified. Myomectomy or subtotal hysterectomy was performed in 15 patients, and 30 patients underwent total hysterectomy as the initial surgery. Of the patients who underwent myomectomy or subtotal hysterectomy as the initial surgery (n?=?15), 14 were re-explored to complete staging. Of the patients who underwent re-exploration (n?=?14), five (35.8 %) had remnant sarcoma on the remaining uterus and no patients had disseminated disease. A Kaplan-Meier curve and log-rank test showed no difference in progression-free survival (P?=?0.941) between the two groups. CONCLUSION: Initial uterus-preserving surgery does not appear to be associated with an adverse impact on survival outcomes for unexpected uterine sarcoma when surgical re-exploration was performed immediately. As such, surgical re-exploration may be useful for removing any remnant sarcoma.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Wun(김상운) ORCID logo https://orcid.org/0000-0002-8342-8701
Kim, Sung Hoon(김성훈) ORCID logo https://orcid.org/0000-0002-1645-7473
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Kim, Hyun-Soo(김현수)
Nam, Eun Ji(남은지)
Lee, Jung-Yun(이정윤) ORCID logo https://orcid.org/0000-0001-7948-1350
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