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Study in JAMA Urges Caution In Patients Over 50

Study in JAMA Urges Caution In Patients Over 50

On February 19, 2015, the Journal of the American Medical Association Oncology published an investigation on the use of power morcellators and the prevalence of hidden uterine cancer in women who undergo myomectomy. The lead researcher, Dr. Jason Wright, is the Division Chief of Gynecologic Oncology at Columbia University, New York City, and an internationally recognized expert in gynecologic cancer management.

The study reported that the overall prevalence of uterine cancer in women who underwent myomectomy with LPMs was 0.09%, or 1 in 1073 women. However, the authors noted that myomectomies are “generally… performed in younger women”, and their research concluded that advanced age is the strongest risk factor for uterine cancer. For example, the prevalence of uterine cancer in women 60 years or older was over 54 times higher than in women younger than 40 years. The investigation also found that 1 in 230 women who underwent myomectomy with power morcellators had pathologic findings of the uterus, in the form of either cancers or “precancerous abnormalities.” Furthermore, the study concluded the prevalence of uterine cancer in women who underwent myomectomy has increased with time – from 0.13% in 2006 to 0.32% in 2012.

Given the above findings, the authors recommended that “…power morcellation should be approached with caution in patients older than 50 years undergoing myomectomy.” The researchers also observed that “[l]ittle is known about the risk of possible tumor dissemination in women who undergo myomectomy either with or without morcellation.” Finally, the authors cautioned that “[f]or… women who undergo hysterectomy with [power morcellators] and are ultimately found to have a uterine leiomyosarcoma, the risk of [cancer] dissemination is substantial.”