Morcellation in gynecologic oncology

Purpose of review Morcellation of uteri with unsuspected malignancies has been the focus of reports for decades. More intensive evaluation of clinical outcomes and evaluation of impact of changes in practice has occurred since the release of FDA statement advising against the use of power morcellators. The review summarizes some of the most relevant publications on this topic. Recent findings The Society of Gynecologic Oncology and the American College of Obstetricians and Gynecologists concur that symptomatic women should undergo appropriate evaluation, morcellation should not be performed whenever malignancy is suspected or diagnosed, and acknowledge the limitations of diagnostic testing currently available to detect leiomyosarcoma. Accurate incidence of occult leiomyosarcoma in women undergoing hysterectomy for symptomatic myomas is not known because of poor quality of data. Increased complication rates, including death, with abdominal procedures and increased societal costs have been reported. The FDA safety communication has resulted in decreased laparoscopic hysterectomy rates. Summary Clinical judgement and practice in accordance to clinical guidelines, based on best current scientific evidence, is recommended. Women should be aware of the limitation of current data regarding the incidence of occult leiomyosarcoma or other malignancies whenever consenting to any form of therapy for symptomatic myomas, including surgical, medical and expectant management. If sur...
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: GYNECOLOGIC MORCELLATION: Edited by David L. Olive Source Type: research