Incidence and Predictors of Unexpected Malignancy in Benign Myomectomy or Hysterectomy.

Autor:	Sabt FY; Department of Obstetrics and Gynecology, Salmaniya Medical Complex, Manama, BHR., Isa HM; Department of Pediatrics, Arabian Gulf University, Manama, BHR.; Department of Pediatrics, Salmaniya Medical Complex, Manama, BHR., Khudair ZA; Department of Obstetrics and Gynecology, Salmaniya Medical Complex, Manama, BHR., Khedr EE; Department of Public Health, Benha University, Benha, EGY., Alkhan FA; Department of Obstetrics and Gynecology, Al Salam Specialist Hospital, Riffa, BHR., Hammad JS; Department of Obstetrics and Gynecology, Salmaniya Medical Complex, Manama, BHR.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Aug 14; Vol. 16 (8), pp. e66880. Date of Electronic Publication: 2024 Aug 14 (Print Publication: 2024).
DOI:	10.7759/cureus.66880
Abstrakt:	Introduction Detection of gynecological cancers preoperatively is imperative for practitioners for optimal patient management and outcome. This study aimed to estimate the incidence of unexpected malignancy (UM) in patients who underwent hysterectomy or myomectomy for presumed benign indications and to detect the predictive factors of UM. Methods A retrospective analytical study that included patients who underwent hysterectomy or myomectomy for benign indications from January 1st, 2016, to December 31st, 2020, was conducted at the Department of Obstetrics and Gynecology at Salmaniya Medical Complex, Bahrain. The main outcome was the overall incidence of UM and the incidence of each malignancy. Characteristics of UM were compared with benign pathologies. Fisher's exact and Pearson's chi-square tests were used to compare categorical variables and the Mann-Whitney U test or student's t-test for continuous variables. Binary logistic regression was used to identify the predictors of occurrence of UM. Confidence interval (CI) was set at 95%. A probability value (p-value) less than 0.05 was considered statistically significant. Results Out of 513 patients who underwent hysterectomy or myomectomy, 379 (73.9%) fulfilled the inclusion criteria, 314 (82.8%) hysterectomies and 65 (17.2%) myomectomies. The overall incidence of UM was 1.3% (n=5/379), 1.3% (n=4/314) among hysterectomies and 1.5% (n=1/65) among myomectomies. Three (0.8%) pre-malignant pathologies were identified: one (0.26%) smooth muscle tumor of unknown malignant potential, leiomyoma with bizarre nuclei, and mucinous borderline tumor of endocervical type of ovary each. The types of UM were sarcomas in three (0.26%) patients (two (0.5%) leiomyosarcoma and one (0.26%) endometrial stromal sarcoma) and endometrial adenocarcinoma and ovarian cancer in one (0.26%) patient each. No significant difference was found between the characteristics of UM and benign pathologies. Conclusion Although this study demonstrated a low incidence of UM among both hysterectomies and myomectomies, the age at the diagnosis of our patients with UM was as young as 34 years of age, and sarcomas were the most common type of UM. Disconcertingly, none of the studied independent variables had significantly predicted the occurrence of UM. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Research and Research Ethics committee, Salmaniya Medical Complex, Government Hospitals issued approval 2100123. This study conforms to the provisions of the Declaration of Helsinki in 1995 (revised in Edinburgh 2000) and was approved by the Research and Research Ethics Committee, Salmaniya Medical Complex, Government Hospitals (Institutional Review Board number: 2100123). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Sabt et al.)
Databáze:	MEDLINE
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