Prevalence of Uterine Malignancy at Hysterectomy with Morcellation

Large database allows estimate of preexisting cancer, but many questions remain.

Following a highly publicized case in which a uterine sarcoma was apparently upstaged as a consequence of fibroid removal performed with morcellation (NEJM JW Womens Health Feb 25 2014), this practice is receiving greater scrutiny. To assess the likelihood of preexisting malignancy at the time of morcellation, investigators analyzed an insurance database including 232,882 U.S. women who had minimally invasive hysterectomies between 2006 and 2012.

Among the 36,470 women (15.7%) who underwent morcellation, 99 cases of uterine cancer were observed (prevalence, 27/10,000). Other gynecologic neoplasia (including cervical, ovarian, and tubal malignancies as well as endometrial hyperplasia) were identified in an additional 26 women (7/10,000). Risk…

Reviewing Author

Andrew M. Kaunitz MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Andrew M. Kaunitz MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Prevalence of Uterine Malignancy at Hysterectomy with Morcellation

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Reviewing Author