کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6183192 1254090 2015 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Impact of morcellation on survival outcomes of patients with unexpected uterine leiomyosarcoma: A systematic review and meta-analysis
ترجمه فارسی عنوان
تاثیر بروز بر پیامدهای زنده ماندن بیماران مبتلا به لئومیوسارکوم غیر منتظره رحم: بررسی منظم و متاآنالیز
کلمات کلیدی
سارکوم رحم، لیومیوسارکوم، مرزبندی، مرکل قدرت عود،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی زنان، زایمان و بهداشت زنان
چکیده انگلیسی


- Intra-abdominal morcellation of unexpected leiomyosarcoma is related to a 4-fold increase in intra-abdominal recurrence rate.
- Owing to the limited evidence about the effects of morcellation on patients with undiagnosed leiomyosarcoma, further studies are warranted.

ObjectiveTo review the current evidence on the effects of intra-abdominal morcellation on survival outcomes of patients affected by unexpected uterine leiomyosarcoma (ULMS) and to estimate the risk of recurrence in those patients.MethodsPubMed (MEDLINE), Scopus, Embase, Web of Science databases as well as ClinicalTrails.gov, were searched for data evaluating the effects of intra-abdominal morcellation on survival outcomes of patients with undiagnosed ULMS. Studies were evaluated per the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) and the American College of Obstetricians and Gynecologists (ACOG) guidelines.ResultsSixty manuscripts were screened, 11 (18%) were selected and four (7%) were included. Overall, 202 patients were included: 75 (37%) patients had morcellation of ULMS, while 127 (63%) patients had not. A meta-analysis of these studies showed that morcellation increased the overall (62% vs. 39%; OR: 3.16 (95% CI: 1.38, 7.26)) and intra-abdominal (39% vs. 9%; OR: 4.11 (95% CI: 1.92, 8.81)) recurrence rates as well as death rate (48% vs. 29%; OR: 2.42 (95% CI: 1.19, 4.92)). No between-group difference in cumulative extra-abdominal recurrence (OR: 0.34 (95% CI: 0.07, 1.59)) rate was observed.ConclusionsOur data support a significant correlation between uterine morcellation and an increased risk of intra-abdominal recurrence in patients affected by unexpected ULMS. However, the limited data on this issue and the absence of high level of evidence suggest the need of further studies designed to estimate the risk to benefit ratio of morcellation in patients with uterine fibroids and undiagnosed ULMS.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Gynecologic Oncology - Volume 137, Issue 1, April 2015, Pages 167-172
نویسندگان
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