Impact of circulating tumor cells (CTCs) on overall survival among patients treated with chemotherapy plus bevacizumab for advanced cervical cancer: An NRG Oncology/Gynecologic Oncology Group study

while 33% of the NMOR cohort underwent preoperative biopsy compared with 44.8% of the MORC cohort (P=NS). Median uterine weight was 296 g in the MOR and 184 g in the NMOR cohorts (P=0.004). Two occult uterine cancers were detected in the entire cohort (0.09% malignancy risk, n = 2173 pts). Only one case of leiomyosarcoma (LMS; 0.04% risk) and one case of microinvasive cervical cancer were detected, both in the MOR cases. Both are without evidence of disease with overall survival of 45.6 (LMS case) and 18 months (cervical case), respectively. No occult uterine cancers were identified in women b50 years old in the entire cohort. Conclusions: The risk of occult uterine malignancy in women undergoing uterine surgery for presumed benign disease at a highvolume MIS center was low, and was 0% in reproductive-age women. Comprehensive preoperative assessments and patient risk stratification for occult malignancy may optimize patient safety and reduce the risk of morcellator-associated morbidity.