Quantifying Risk for Occult Uterine Sarcoma Found at Hysterectomy for Fibroids

Surgical morcellation of a previously unidentified uterine sarcoma may cause inadvertent spread of the malignancy within the abdomen. Hence, quantifying risk for occult uterine sarcoma at the time of hysterectomy for fibroids (leiomyomas) is important because the presence of a sarcoma would contraindicate the use of morcellation.

Among some 3.1 million women served by Kaiser Permanente from 2006 to 2013, 34,600 hysterectomy procedures were performed for presumed benign uterine fibroids. In this cohort, 1 occult uterine sarcoma was identified for every 278 hysterectomy procedures. Risk for occult sarcoma was higher among women older than 50. Two thirds of occult sarcomas were leiomyosarcomas. A total of 111 women with stage I leiomyosarcoma h…