Morcellation may be a less invasive option for removing the uterus but it carries with it serious risks. The procedure, which divides uterine tissues into smaller pieces so they can be easily removed through a small cut in the abdomen, is associated with possibilities of spreading undetected cancer, the Food and Drug Administration (FDA) has warned, and findings of a new study appears to validate this concern as researchers found that many women undergoing hysterectomy have hidden cancer.
For the new study that was published in the Journal of the American Medical Association (JAMA) on July 22, Jason Wright, from the Department of Obstetrics and Gynecology at the Columbia University College of Physicians and Surgeons in New York, and colleagues used an insurance database to examine the data of women who underwent minimally invasive hysterectomy between the years 2006 and 2012. Of the 232,882 patients they have identified, 36,470 had power morcellation.
The researchers found that 99 of the women who had power morcellation were later found to have uterine cancer. The researchers said that this means that 27 in 10,000 women who undergo hysterectomy had cancerous tumors that could be spread by morcellation.
"Our data demonstrate that uterine cancers occurred in 27 per 10,000 women undergoing morcellation. Other malignancies and precancerous abnormalities were also detected," the researchers wrote. "Although data are limited, women with apparent uterine-confined neoplasms at the time of morcellation have been found to have intraperitoneal tumor dissemination at the time of reexploration."
The findings back up concerns that were earlier raised by the FDA that one in 350 women who undergo hysterectomy or surgery to remove non-cancerous tumors had undetected uterine cancer, which puts them at risk if they opt for morcellation.
"With this procedure, you are breaking up the uterus," Wright told Healthday. "You are essentially cutting through a cancer [if it is present] and that could theoretically spread the cancer to outside the uterus."
Doctors who refused to take heed of FDA's recommendation against power morcellators argued that the risk of hidden cancer is not high in younger women but the researchers found that 32 percent of the patients who were found to have undetected uterine cancer were 50 years old and younger
The risk for underlying cancer, however, does increases with age. Only six of the women below 40 years old had uterine cancer detected after undergoing morcellation, which shows a difference of 36 percent when compared with 24 women who were at least 65 years old.
