IMR Press / EJGO / Volume 41 / Issue 3 / DOI: 10.31083/j.ejgo.2020.03.5435
Open Access Original Research
Likelihood of incidental finding of gynecological cancer in women undergoing hysterectomy for benign indications
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1 Abant Izzet Baysal University Hospital Department of Gynecology and Obstetrics 14280, Golkoy, Bolu, Turkey
2 Department of Pathology, Bolu Abant Izzet Baysal University, Training and Research Hospital, 14280, Golkoy, Bolu, Turkey
3 Department of Obstetrics and Gynecology, Bolu İzzet Baysal State Hospital, 14300, Tabaklar district, Bolu, Turkey
Eur. J. Gynaecol. Oncol. 2020 , 41(3), 402–407; https://doi.org/10.31083/j.ejgo.2020.03.5435
Submitted: 20 November 2019 | Accepted: 20 May 2020 | Published: 15 June 2020
Abstract

Objective: The aim of this study was to determine the incidence of unexpected gynecological malignancy (UGM) after hysterectomy performed for benign indications. Methods: We analysed patient sample data extracted from a medical database between 1 January 2007 and 10 August 2019 for 2740 women who underwent a hysterectomy for benign indications. The Kolmogorov-Smirnov test, Kruskal-Wallis test and Chi-square test were performed. Statistical significance was reached if p < 0.05. Results: The most common primary indications for hysterectomy were leiomyomata (1403, 51%), abnormal uterine bleeding (784, 28.61%), and pelvic organ prolapse (504, 18.39%). A laparotomic, laparoscopic or vaginal hysterectomy was performed in 1452 (53%), 836 (30.5%) and 452 (16.5%) women, respectively. unexpected gynecological malignancy after hysterectomy was diagnosed in 22 (0.80%) women. The incidence of unexpected uterine malignancies (UUM), unexpected endometrial cancer, and unexpected uterine malignancies without endometrial cancer was 0.54%, 0.40% and 0.14% respectively. Mean ages were not significantly different for abdominal, laparoscopic and vaginal hysterectomy groups (51.75 ± 9.83, 51.32 ± 9.51, 51.39 ± 10.04 years respectively, p = 0.299). No significant difference in the incidence of unexpected gynecological malignancy was noted between the groups [laparotomy 0.47%, laparoscopy 0.22%, vaginal 0.11%, p = 0.066]. The incidence of unexpected leiomyosarcoma [laparatomic 0.11%, laparascopic 0.03%, vaginal 0.0%] and unexpected endometrial carcinoma [laparatomic 0.26%, laparascopic 0.11%, vaginal 0.03%] was significantly higher in abdominal and laparascopic hysterectomy groups than the vaginal hysterectomy group and no significant difference was observed between the abdominal and laparoscopic hysterectomy groups (p = 0.037, p = 0.028, p = 0.108, respectively). Conclusion: The incidence of unexpected gynecological malignancy diagnosed after hysterectomy performed for benign conditions was very low, if the correct indications were selected.

Keywords
Hysterectomy
Uterine malignancy
Unexpected malignancy
Benign indication
Unexpected gynecologic malignancy
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