Incidence and groups at risk for unexpected uterine leiomyosarcoma: a Dutch nationwide cohort study.

Autor: van den Haak L; Department of Gynecology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. l.van_den_haak@lumc.nl., de Kroon CD; Department of Gynecology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands., Warmerdam MI; Department of Gynecology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands., Siebers AG; The Nationwide Network and Registry of Histo- and Cytopathology in The Netherlands, Utrecht, The Netherlands., Rhemrev JP; Department of Obstetrics and Gynecology, Haaglanden Medisch Centrum, The Hague, The Netherlands., Nieboer TE; Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands., Jansen FW; Department of Gynecology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.; Department BioMechanical Engineering, Delft University of Technology, 2628 CD, Delft, The Netherlands.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2019 Jan; Vol. 299 (1), pp. 159-165. Date of Electronic Publication: 2018 Nov 30.
DOI: 10.1007/s00404-018-4949-4
Abstrakt: Objective: To estimate the risk of uterine leiomyosarcoma in patients undergoing gynecological surgery and also to identify groups at risk for unrecognized uterine leiomyosarcoma.
Methods: A national cohort study was performed evaluating all uterine leiomyosarcoma (ULMS) diagnosed in The Netherlands between January 2000 and September 2015. Cases were identified and supplied by the nationwide network and registry of histo- and cytopathology in The Netherlands (PALGA). Unexpected and expected ULMS were compared. Approval for this study was granted by the Medical Ethics Committee of all participating hospitals and by the review board of PALGA.
Results: 262 original cases were included. The overall incidence of ULMS in our study was 0.25% or 1:400 patients. The incidence of unexpected ULMS was 0.12% or 1:865 patients. Preoperatively, a malignancy was unexpected in 46% of the cases and expected in 54%. Abnormal uterine bleeding constituted most of the symptoms. 90% of women underwent abdominal hysterectomy and/or bilateral salpingo-oophorectomy.
Conclusions: Leiomyosarcoma are rare. Women aged 40-50 years with abnormal uterine bleeding are most at risk for unexpected ULMS. In contrast, this risk is low in postmenopausal women. ULMS were highly uncommon in women aged under 40 years.
Databáze: MEDLINE
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