Risk of unexpected sarcoma being discovered after hysterectomy appears fairly low

ANN ARBOR, Mich. — 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.”

In addition to As-Sanie, the study's authors include IHPI members Daniel Morgan, M.D., and Darrell Campbell, Jr., M.D. The study used data from the Michigan Surgical Quality Collaborative database.