Population-Based Estimates of the Prevalence of Uterine Sarcoma Among Patients With Leiomyomata Undergoing Surgical Treatment | Geriatrics | JAMA Surgery | JAMA Network
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Research Letter
April 2015

Population-Based Estimates of the Prevalence of Uterine Sarcoma Among Patients With Leiomyomata Undergoing Surgical Treatment

Author Affiliations
  • 1Department of Healthcare Policy and Research, Weill Medical College of Cornell University, New York, New York
  • 2Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York–Presbyterian Hospital, New York
  • 3Department of Urology, Weill Medical College of Cornell University, New York–Presbyterian Hospital, New York
  • 4Patient-Centered Comparative Effectiveness, Program and Medical Device Epidemiology Network’s Science and Infrastructure Center, Weill Medical College of Cornell University, New York–Presbyterian Hospital, New York
JAMA Surg. 2015;150(4):368-370. doi:10.1001/jamasurg.2014.3518

Uterine leiomyomata are one of the most common gynecologic problems among women in the United States, with an annual diagnosis range from 2.0 to 12.8 per 1000 reproductive-age women.1 Intervention is a standard management for symptomatic patients, and various procedures include open and laparoscopic hysterectomy, myolysis, uterine artery embolization, and magnetic resonance–guided focused ultrasonographic surgery.

The practice of electric morcellation has been used by gynecologic surgeons during laparoscopic and robotic-assisted hysterectomies and myomectomies as a less invasive alternative to open surgery.2 In April 2014, the US Food and Drug Administration (FDA) stated that they discouraged the use of this technique over concern that morcellation may spread unsuspected sarcoma tissue.3,4 Based on the literature, the FDA reported that 1 in 352 women have unsuspected uterine sarcoma while undergoing surgery for presumed benign leiomyoma.5 A recent study6 using an all-payer database found that 1 in 368 women who underwent morcellation had uterine cancer. However, the estimates in this study6 were limited by the selective participation of hospitals and by the lack of pathologic confirmation. The literature estimates used by the FDA are prone to referral and reporting bias. We sought to determine the population-based estimates of the prevalence of uterine sarcoma, as well as the risks of major complications following open surgery.

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