Uterine smooth muscle tumor of uncertain malignant potential: A retrospective analysis

Division of Gynecologic Oncology, Baylor College of Medicine, Houston, TX, USA.
Gynecologic Oncology (Impact Factor: 3.69). 04/2009; 113(3):324-6. DOI: 10.1016/j.ygyno.2009.02.020
Source: PubMed

ABSTRACT This retrospective study was designed to evaluate the clinicopathologic features and outcomes of a cohort of patients diagnosed with uterine smooth muscle tumor of uncertain malignant potential (STUMP) seen at a single institution.
All patients diagnosed with uterine STUMP and seen between 1990 and 2005 at The University of Texas M. D. Anderson Cancer Center were identified using the institution's databases. Variables of interest included age at diagnosis, recurrence rate, and disease-free and overall survival.
Forty-one patients with uterine STUMP were identified and included in the study. The mean age at diagnosis was 43 years (range 25-75 years). The mean follow-up time was 45 months (range 1-171 months). Three patients (7.3%) had a recurrence during the follow-up period. One of the three patients who had recurrent disease was found to have a leiomyosarcoma at the time of recurrence. Recurrence rates were similar for women who underwent myomectomy and those who underwent hysterectomy. All three patients with recurrence were alive and disease-free at a mean follow-up time of 121 months.
Our results suggest that in this cohort of patients with uterine STUMP the recurrence rate was 7%. Recurrences can be in the form of STUMP or leiomyosarcoma.

  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper gives a broad overview of developments in the miniaturization of manufacturing processes. The following topics are covered: nanochemistry; nanofabrication; biomimetics; MEMS; parallel and molecular self-assembly; biotechnology; molecular diagnostics; biosensors and microsensors.
    Device Research Conference, 2002. 60th DRC. Conference Digest; 02/2002
  • Value in Health 05/2004; 7(3):279-280. DOI:10.1016/S1098-3015(10)62247-4 · 2.89 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Laparoscopic myomectomy can be performed by most advanced laparoscopic gynecologic surgeons if they have appropriate mentoring. Despite this, it is still an underused procedure. In this article, we report our ten-year experience with laparoscopic myomectomy with focus on blood loss and hemostasis. From July 1999 to May 2009, forty-one patients from our suburban gynecology practice underwent laparoscopic myomectomies which were performed by one surgeon (Dr Heaton). We studied the most important factors that affect the completion of the procedure without conversion to the open route. Fibroids measured up to 15.6 cm on preoperative ultrasound and weighed up to 555 g from pathology report with no malignancy found. Eight patients were treated with Lupron before surgery to reduce the size of the fibroids. Pitressin was used in twenty-three patients during surgery to decrease bleeding. Nineteen cases required morcellation. Blood loss range was 20-1,200 cc and was dependent on the myoma size. One case required staged myomectomy because of bleeding (800 cc) after the large fibroid was removed. No patient required transfusion. No patient required conversion to the open technique. Patients were discharged the day of surgery in the majority of cases. No infections occurred. Two patients had successful pregnancies after myomectomy in this series and were delivered by C-section. Subsequent hysterectomy was performed in six patients at 3-72 months. Laparoscopic myomectomy is a safe procedure in the hands of an experienced advanced laparoscopic surgeon. Blood loss is dependent on the myoma size and bleeding is the most serious intraoperative complication which may require performing a staged laparoscopic myomectomy, conversion to open myomectomy or blood transfusion. Maintaining homeostasis is the chief requirement to successfully and uneventfully complete the procedure without conversion to the open route.
    Archives of Gynecology 07/2009; 281(4):645-9. DOI:10.1007/s00404-009-1154-5 · 1.28 Impact Factor
Show more