Incidence of Occult Leiomyosarcoma in Presumed Morcellation Cases: A Database Study [17P]

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Abstract

INTRODUCTION:

The purpose of this study is to estimate the incidence of unexpected uterine leiomyosarcoma (ULMS) in patients who received laparoscopic myomectomy (LM) or laparoscopic supracervical hysterectomy (LSH). Also, we aim to calculate the incidence rates in different age groups.

METHODS:

This study was performed using health insurance claims data from Clinformatics DataMart. Data were collected from 2002 to 2011. Diagnoses and procedures were identified based on International Classification of Diseases, Ninth Revision, Clinical Modification and Current Procedural Terminology codes. Participants were aged 25 to 64 years who were diagnosed with leiomyoma and underwent LSH or LM. Age was categorized into 3 groups: 25–39, 40–49, and 50–64.

RESULTS:

Our study population included 13,964 women. The incidence of ULMS was 1.4 per 1,000. For the 25–39, 40–49, and 50–64 age groups, the incidence rates after LSH were 9.8, 10.7, and 33.4 per 1000, respectively. The incidence rates after LM were 0.0, 33.8, and 90.1 per 1,000, respectively. In the multivariate logistic regression, age was the only statistically significant factor. Ages 50–64 were associated with a significant increase in risk of ULMS (OR 1.5, 95% CI= 1.3–14.2 for all subjects; OR=3.0, 95% CI=0.9–10.5 for LSH; and OR=33.8, 95% CI=1.7–100+ for LM).

CONCLUSION:

Our analysis shows the risk of being diagnosed with ULMS increases after age of 50 in patients receiving LSH and age of 40 in those with myomectomy. This study may allow physicians to assess patient risk based on age, which will lead to a more accurate informed consent process.

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