I've had a healthy monstera for 3 years, so my experience is limited, but here is what I have observed:

- It has continued new growth and occasional recycling (yellowing, browning) of individual leaves during the 3 years, with no root pruning or repotting.

- It grew too big for my space and I pruned it quite severely to no ill effect...the new growth continued. When I pruned, I cut off the oldest and/or ugliest stems, and generally pruned for looks.

- I cut the wandering root tentacles when they bug me, to no ill effect.

- My plant is pretty forgiving when I let it get dry.

- In general, my plant has been very vigorous and it hasn't yet punished me for being uncautious/lazy.

I think your plant looks healthy and it is maybe a little overgrown for my taste (aesthetics, not health), but I don't think that will hurt it as a whole - it would just recycle its oldest leaves, or maybe some of the new growth won't thrive.

I'd prune it so it looks like how you want, or a bit smaller, and also try propagation if you want.

I can't advise much on propagation - suggest to look it up - but one general rule I've seen about propagation from cuttings is that you don't want to have more top-growth than what your cutting's roots (or lack thereof) can support. My gut says that if you cut the marked piece, you should reduce its top growth significantly so the roots aren't overburdened.