None of a wide variety of factors evaluated predicted the risk of uterine sarcoma in these patients undergoing morcellation, Dr. Hartzell said.
Among the 2,582 women who did not undergo power morcellation, uterine sarcoma was identified in 5 patients, or 0.2%. Four were alive without evidence of disease after at least 37 months of follow-up. The fifth patient, who had high-grade leiomyosarcoma, died from her disease 2 years after diagnosis.
“The patient about to undergo a minimally invasive procedure with possible power morcellation should be counseled about the possible consequences of morcellation of an undiagnosed malignancy. Alternatives such as mini-laparotomy or an open procedure should be offered. At our institution, we are also now performing morcellation within a tissue containment bag,” she said.
“Given the well-known advantages of laparoscopic surgery and the rarity of uterine sarcomas, it is our opinion that the risk of morcellation of occult malignancy is insufficient to abandon power morcellation,” Dr. Hartzell added.
The researchers reported that they had no relevant conflicts of interest.