Morcellator Use Tied To Increased Risk Of Death In Women With Uterine Sarcoma: Study

The findings of a new study provide more support for the medical community’s recent abandonment of power morcellators, which were previously used during many laparoscopic hysterectomy procedures, but spread hidden cancer cells within the uterus.

In a study published earlier this month in the Journal of Clinical Oncology, researchers from Yale University indicate women with occult uterine sarcoma face a higher risk of death after undergoing a hysterectomy during which uncontained power morcellation was used.

Morcellators are medical devices which allow doctors to cut up and remove the uterus and uterine fibroids through a small incision in the abdomen. The minimally invasive procedures were recommended as a way to limit the risk of surgical complications and reduce recovery time. However, use of the devices has largely been abandoned over the last several years, since the medical community discovered morcellators may spread undiagnosed cancer cells contained within the uterus, leading to the rapid upstaging of leiomyosarcoma, endometrial stromal sarcoma and other difficult to treat cancers.

In this latest study, researchers looked at statewide hospital discharge records in New York, identifying 843 women with occult endometrial carcinoma and 334 women with occult uterine sarcoma who underwent a hysterectomy or myomectomy from October 1, 2003 through December 31, 2013. They compared the results of those who underwent a total abdominal hysterectomy with those who underwent laparoscopic hysterectomy or myomectomy involving power morcellation.

According to the findings, women with uterine sarcoma who underwent power morcellation saw nearly triple the risk of death from their cancer than women who did not. The death rate was even higher, nearly four times the risk, if they had leiomyosarcoma and underwent power morcellation.

There appeared to be no link between the procedure and increased risk of death from endometrial carcinoma, however.

“Uncontained power morcellation was associated with higher mortality risk in women with occult uterine sarcoma, especially in those with occult leiomyosarcoma,” the researchers determined.

In November 2014, the FDA decided to add a black box warning to power morcellators about the cancer risk, and provided guidance on the limited instances where laparoscopic hysterectomies may be warranted.

In the aftermath, Johnson & Johnson faced dozens of morcellation cancer lawsuits brought on behalf of women who suffered problems after a laparoscopic procedure, and wrongful death claims by family members of women who had died of such cancers. Most of those cases have been resolved through morcellator settlement agreements.