Objective
Minimally invasive surgery results in shorter recovery and improved quality of life. The removal of the uterus or fibroids using morcellators to fragment the specimen can potentially spread unsuspected malignancy and result in poor prognosis. Uterine leiomyosarcomas (LMS) comprise only 3% of uterine malignancies, but have similar characteristics to uterine fibroids. Serum biomarkers and radiologic diagnostic criteria to preoperatively identify LMS have not been widely adopted. Factors related to increased risk of LMS in patients with presumed benign leiomyoma, including older age and black race, have not been well defined. We studied demographic and clinical characteristics of LMS patients to further characterize the clinical profile of LMS.
Study Design
Data from 2010 through 2011 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute. Histology codes for LMS were based on the International Classification of Diseases, Ninth Revision . We provide descriptive statistics for all extracted cases, and identify a subset of patients based on 4 characteristics that may be used to help prevent the morcellation of LMS. Statistical analyses were 2-sided and performed with software (SAS, version 9.3; SAS Institute, Cary, NC). A P value < .05 was considered statistically significant. Since SEER is a nationwide, deidentified database, our study was exempt from approval by our institutional review board.
Study Design
Data from 2010 through 2011 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute. Histology codes for LMS were based on the International Classification of Diseases, Ninth Revision . We provide descriptive statistics for all extracted cases, and identify a subset of patients based on 4 characteristics that may be used to help prevent the morcellation of LMS. Statistical analyses were 2-sided and performed with software (SAS, version 9.3; SAS Institute, Cary, NC). A P value < .05 was considered statistically significant. Since SEER is a nationwide, deidentified database, our study was exempt from approval by our institutional review board.
Results
We identified 491 LMS patients, the demographic and clinicopathologic details of whom are provided in the Table . Younger (<55 years) patients were more likely to have smaller (≤5 cm) tumors confined to the uterus compared to older women (66% vs 33%; P = .12). Of the reproductive age (≤45 years) patients with stage IA disease (intrauterine disease, tumors ≤5 cm), 50% (6/12) were black. We selected known risk factors including age, race, tumor size, and extrauterine (stage II-IV) disease to better characterize patients with LMS. Over 98.7% of LMS patients had ≥1 of 4 factors: older age, black race, larger (>5 cm) tumor size, and extrauterine disease.
