Pritts Elizabeth A
Wisconsin Fertility Institute, Middleton, Wisconsin, USA.
Curr Opin Obstet Gynecol. 2018 Feb;30(1):81-88. doi: 10.1097/GCO.0000000000000430.
To review the data-derived prevalence rates for occult leiomyosarcoma (LMS), and outcomes for women who have these tumors inadvertently morcellated.
In 2014, the Food and Drug Administration presented data showing the prevalence rates of occult LMS at 2.02/1000 surgeries for presumed benign fibroids. They also attributed poorer outcomes for women undergoing power morcellation of these tumors. Two more recent meta-analyses have shown much lower rates, as low as one in 8300 surgeries when including only prospective studies, and one in 1428 surgeries when including both prospective and retrospective studies. When looking at outcomes, both studies show no difference in outcomes when comparing power or any other type of morcellation. The most recent data suggest that even intact removal has no advantage when looking at mortality rates.
Prevalence of occult LMS remains quite rare, but outcomes after intact removal or any type of morcellation appear to be no different.
回顾隐匿性平滑肌肉瘤（LMS）的数据推导患病率，以及这些肿瘤被意外粉碎的女性的治疗结果。
2014年，美国食品药品监督管理局公布的数据显示，隐匿性LMS在假定为良性肌瘤的手术中的患病率为2.02/1000。他们还指出，这些肿瘤接受动力粉碎术的女性预后较差。最近的另外两项荟萃分析显示患病率要低得多，仅纳入前瞻性研究时低至8300例手术中有1例，同时纳入前瞻性和回顾性研究时为1428例手术中有1例。在观察治疗结果时，两项研究均表明，比较动力粉碎术或任何其他类型的粉碎术时，治疗结果没有差异。最新数据表明，即使完整切除，在死亡率方面也没有优势。
隐匿性LMS的患病率仍然相当低，但完整切除或任何类型的粉碎术后的结果似乎没有差异。
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