title: Incidence of occult leiomyosarcoma in presumed morcellation cases: a database study.
abstract: Our objective was to estimate the incidence of uterine leiomyosarcoma in patients with leiomyomas following laparoscopic supracervical hysterectomy and myomectomy procedures.
  
  
  
  For this study, we analyzed records of 13,964 women aged 25-64 years who underwent laparoscopic supracervical hysterectomies or myomectomies for leiomyomas from 2002 to 2011 using Clinformatics DataMart. Patient records were divided into two groups: history of laparoscopic supracervical hysterectomy and history of myomectomy. Subjects were tracked to identify diagnosis of leiomyosarcoma within 1 year of the procedure. We analyzed data from the 25-39, 40-49, and 50-64 age brackets. Evidence was obtained from a cohort study from national private insurance claims in the US.
  
  
  
  Our results showed the incidence of occult leiomyosarcoma developing within 1 year following supracervical hysterectomy using a laparoscopic-assisted approach are 9.8, 10.7, and 33.4 per 10,000 for the 25-39, 40-49, and 50-64 age brackets, respectively; the overall incidence rate is 13.1 per 10,000. The incidence rate of occult leiomyosarcoma developing within 1 year following myomectomy using a laparoscopic-assisted approach are 0.0, 33.8, and 90.1 per 10,000 for the 25-39, 40-49, and 50-64 age brackets, respectively; the overall incidence rate is 17.3 per 10,000.
  
  
  
  Our analysis shows the overall risk of being diagnosed with occult leiomyosarcoma is 12.9 per 10,000 in laparoscopic-assisted supracervical hysterectomy and myomectomy for patients younger than 49. There is no evidence of occult leiomyosarcoma 1 year after operation for patients younger than 40 who underwent laparoscopic myomectomy.
authors.affiliation: Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, TX, USA.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Rodriguez
authors.forename: Burak
authors.lastname: Zeybek
authors.affiliation: Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, TX, USA.
authors.forename: Mehmet R
authors.initials: MR
authors.lastname: Asoglu
authors.affiliation: Dicle University, Diyarbakir, Turkey.
authors.forename: Muhammet Erdal
authors.initials: ME
authors.lastname: Sak
authors.affiliation: Institute for Translational Sciences, The University of Texas Medical Branch at Galveston, TX, USA; Department of Preventive Medicine and Community Health, The University of Texas Medical Branch at Galveston, TX, USA.
authors.forename: Alai
authors.initials: A
authors.lastname: Tan
authors.affiliation: Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, TX, USA.
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: Borahay
authors.affiliation: Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, TX, USA. Electronic address: gokilic@utmb.edu.
authors.forename: Gokhan S
authors.initials: GS
authors.lastname: Kilic
mesh_terms: D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D010535:Laparoscopy; D007889:Leiomyoma / Q000453:epidemiology* / Q000601:surgery; D007890:Leiomyosarcoma / Q000453:epidemiology* / Q000601:surgery; D008875:Middle Aged; D000069577:Morcellation; D012189:Retrospective Studies; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000601:surgery
keywords: Incidence; Laparoscopy; Leiomyoma; Leiomyosarcoma