|
|
|
|
|
|
|
|
abstract
OBJECTIVE: To define the incidence of unexpected
gynecologic malignancies among women who underwent hysterectomy for
benign indications.
METHODS: We conducted a data analysis of hysterectomy
cases from a quality and safety database maintained by the Michigan
Surgical Quality Collaborative, a statewide group of hospitals that
voluntarily reports perioperative outcomes. Cases were abstracted from
January 1, 2013, through December 8, 2013. Benign preoperative surgical
indications included pelvic mass, family history of cancer, hyperplasia
without atypia, prolapse, endometriosis, pelvic pain, abnormal uterine
bleeding, or leiomyomas. Women with a surgical indication of cancer,
cervical dysplasia, or hyperplasia with atypia were excluded.
RESULTS: During the study period, 7,499 women
underwent a hysterectomy and 85.24% (n=6,360) were performed for benign
indications. The incidence of unexpected gynecologic malignancy among
hysterectomies performed for benign indications was 2.7% (n=172) and
included ovarian, peritoneal, and fallopian tube cancer (n=69 [1.08%]),
endometrial cancer (n=65 [1.02%]), uterine sarcoma (n=14 [0.22%]),
metastatic cancer (n=13 [0.20%]), and cervical cancer (n=11 [0.17%]).
The most common indications for hysterectomy were leiomyomas and
abnormal uterine bleeding. There was no difference in the mean age
(46.86±10.57 compared with 47.0±10.76 years, P=.96) of women
with unexpected sarcoma compared with benign disease. Women with
unexpected sarcoma were more likely to have a history of venous
thromboembolism and preoperative blood transfusion, but this did not
reach statistical significance.
CONCLUSION: The 2.7% incidence of unexpected
gynecologic malignancy includes a 0.22% incidence of uterine sarcoma and
1.02% incidence of endometrial cancer. No reliable predictors of
uterine sarcoma exist and caution is warranted in preoperative planning
for hysterectomy.
LEVEL OF EVIDENCE: II
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.