Key Points
• Source: Journal of Clinical Medicine
• Conclusions: “Tumour morcellation is not associated with OS for pT1 tumours. The morcellation of pT1 LMS seems to prolong the time to distant metastases whereas local recurrence is more likely to occur after the morcellation of pT1 LMS [uterine leiomyosarcoma].”
• German researchers assessed 301 LMS cases and differentiated morcellated and non-morcellated LMS from pT1 and >pT1 tumors. They evaluated time to local recurrence, distant metastases, and patient death.
• At stage pT1, morcellation doubles the locoregional recurrence risk and halves the risk of distant recurrence, with the timing of local recurrence not changing with morcellation.
• “The ‘positive effect’ of morcellation on distant relapses cannot be explained based on the variables studied. The potential effect of chemotherapy on this phenomenon could be excluded. The data may hypothetically suggest that morcellation with the spread of tumour cells in the peritoneal cavity may have a protective effect on the development of distant recurrences via yet unknown mechanisms,” the authors wrote.
• Limitations of the current study include possible informative censoring and its retrospective design.
• “The number of mitoses or the mitotic index seems to be an important factor for all event types and should therefore be determined for each LMS. In particular, the impact of morcellation when adjusting for other prognostic factors for LMS death requires further research. Further prospective analysis must be conducted to confirm our findings,” the authors concluded.