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

作　　者：Hua Yang Xiao-Chuan Li Chen Yao Jing-He Lang Hang-Mei Jin Ming-Rong Xi Gang Wang Lu-Wen Wang Min Hao Yan Ding Jie Chen Jian-Qing Zhang Lu Han Cheng-Xiu Guo Xiang Xue Yan Li Jian-Hua Zheng Man-Hua Cui Huai-Fang Li Guang-Shi Tao Long Chen Su-Min Wang An-Wei LU Ze-Hua Huang Qing Liu Ya-Li Zhuang Xiang-Hua Huang Gen-Hai Zhu Ou-Ping Huang Li-Na Hu Mu-Jun Li Hong-Lin Zhou Jing-Hui Song Lan Zhu 

机构地区：[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, Cbengdu, 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

出　　处：《Chinese Medical Journal》2017年第22期2661-2665,共5页中华医学杂志（英文版）

摘　　要：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 moreellation in patients who undergo laparoscopie myomectomy. Patients with fast-growing uterine fibroids and abnormal ultrasonic tumor blood flow should be considered for malignant potential, and morcellation should be avoided.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 moreellation in patients who undergo laparoscopie myomectomy. Patients with fast-growing uterine fibroids and abnormal ultrasonic tumor blood flow should be considered for malignant potential, and morcellation should be avoided.

关 键 词：Laparoscopic Myomectomy MORCELLATION SARCOMA 

分 类 号：R0[医药卫生]