Home E-Weekly July 29, 2014

Could JAMA Study Lead to Power Morcellation Ban?

Published: July 28, 2014

One out of every 370 women who underwent minimally invasive hysterectomies via power morcellation had uterine cancer, says a recent study published in JAMA, but the significance of that study is widely misunderstood, says an expert in the field.

In a controversial advisory, the FDA recently cautioned against the use of power morcellation in hysterectomies because it can spread cancer in patients who have undetected uterine sarcomas. The agency recently held hearings that could result in an outright ban on power morcellation.

In contrast, however, Elizabeth Pritts, MD, director of the Wisconsin Fertility Institute, argues that people are missing an important distinction in the JAMA study — that uterine sarcoma is a rare subset of uterine cancer, involving only 2% to 4% of all cases. Dr. Pritts, who testified at the FDA hearings, says that she and 6 colleagues will soon publish a paper based on 133 studies that shows the number of patients with undetected sarcomas — those who might unknowingly undergo morcellation and have perilous outcomes — is about 1 in 6,500.

She and other practitioners argue that banning the procedure would do more harm than good, because open surgery is associated with significantly higher rates of morbidity and mortality.

Jim Burger

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