Risiko sarkoma tak terduga yang ditemukan setelah histerektomi muncul cukup rendah--T-REC-komunitas reptil-semarang--KSE-komunitas satwa eksotik

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Risiko sarkoma tak terduga yang ditemukan setelah histerektomi muncul cukup rendah

Uterine sarkoma - jenis kanker yang berpotensi agresif  yang terbentuk di jaringan dalam rahim - ditemukan pada 0,22 % wanita setelah histerektomi untuk kondisi jinak , pada sebuah studi skala besar baru  . author  mengatakan temuan mungkin memiliki implikasi untuk risiko yang terkait dengan morcellation ....read more

Risk of
unexpected sarcoma being discovered after hysterectomy appears fairly low

Date:

February 19, 2015

Source:

University of Michigan
Health System

Summary:

Uterine sarcoma -- a
potentially aggressive type of cancer that forms in tissues in the uterus --
was found in 0.22 % of women following a hysterectomy for benign conditions, a
new large-scale study shows. Authors say findings may have implications for the
risks associated with morcellation.

....................

uterine sarcoma -- a
potentially aggressive type of cancer that forms in tissues in the uterus --
was found in 0.22 % of women following a hysterectomy for benign conditions, a
new large-scale study by the University of Michigan departments of Obstetrics
and Gynecology, and Surgery finds.

Authors say the findings, which appear in this month's issue of Obstetrics
and Gynecology, may have implications for the risks associated with
morcellation -- a minimally invasive procedure that cuts large tissue inside
the body into smaller pieces so it can be removed through smaller incisions.
The FDA recently issued new guidelines on power morcellators, an electrical
device that is used by surgeons to help with morcellation, after concerns that
it could potentially spread unsuspected tumors that appeared as benign
fibroids.

"We found that there is a risk of unexpected cancer discovery at the
time of a hysterectomy for what was presumed to be for a benign or
non-cancerous indication, however, the risk is fairly small," says senior
author Sawsan As-Sanie, M.D., M.P.H, Assistant Professor in the Department of
Obstetrics and Gynecology at the U-M Medical School.

"Caution is warranted in preoperative planning for a hysterectomy, but
for a significant number of women, a minimally-invasive procedure may still be
a very viable and beneficial option. Physicians need to balance optimizing
technologies that have well-known patient-centered benefits while still being
cognizant of the rare but true risk of undiagnosed cancer."

Researchers analyzed 2013 data from a quality and safety database
maintained by the Michigan Surgical Quality Collaborative, a statewide group of
hospitals that voluntarily reports surgical outcomes. The study included 6,360
women who underwent a hysterectomy for benign conditions such as fibroids,
pelvic pain, endometriosis or abnormal uterine bleeding. Benign hysterectomies
account for more than 400,000 surgeries a year nationwide, and symptoms
associated with uterine fibroids remain the most common benign indication for
hysterectomy.

The study found a total 2.7 percent incidence of unexpected cancer in women
who had undergone hysterectomy for benign indications, but the majority of
cases -- 1.02 percent -- were unexpected endometrial cancer. The underlying
reason for the risk of unexpected endometrial cancer is unclear since data was
not available on whether these women underwent endometrial biopsy prior to
surgery, which can detect most but not all cases of endometrial cancer.

However, only 0.22% of hysterectomies performed for benign indications
contained uterine sarcoma. Uterine sarcomas are a rare group of diverse and
potentially aggressive uterine tumors. The risks associated with power
morcellation have received significant attention in the media recently and have
been primarily linked to sarcomas since there are no available methods to
accurately distinguish sarcomas from otherwise benign uterine fibroids before
surgery. This study also found that there were no reliable clinical predictors
of uterine sarcoma before surgery.

As-Sanie notes vaginal surgery is always the preferred route for benign
indications but some women are not candidates for that option. The minimally
invasive laparoscopic hysterectomy--which may include morcellation techniques
when the uterus is too large to remove from the laparoscopic or vaginal
incisions -- means smaller incisions, lower risk of infection and blood loss,
and quicker recovery than the standard abdominal hysterectomy.

"The ultimate goal in the field is to eventually find more reliable
ways to accurately distinguish between benign fibroids and uterine
sarcomas," As-Sanie says. "For now, this data confirms a very low
incidence of unexpected uterine sarcoma and is valuable information to inform
patients and physicians when considering treatment options for fibroid-related
symptoms."

"Our focus is on minimizing risks without taking choices with
potentially better outcomes away from patients that are at low risk of an
undiagnosed cancer."







Story Source:

The above story is based on materials provided by University of Michigan Health
System. Note: Materials may be edited for content and length.







Journal Reference:

1.    Nichole Mahnert, Daniel Morgan, Darrell
Campbell, Carolyn Johnston, Sawsan As-Sanie. Unexpected Gynecologic
Malignancy Diagnosed After Hysterectomy Performed for Benign Indications. Obstetrics
& Gynecology, 2015; 125 (2): 397 DOI: 10.1097/AOG.0000000000000642

http://www.sciencedaily.com/releases/2015/02/150219101637.htm

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