Analyzing 10-year time trends for Hysterectomy and Oophorectomy: Focus on Endometrial sampling and risk factors for Endometrial Cancer

Abstract

Background
Hysterectomy is a versatile and commonly employed treatment option for various benign and malignant gynecological conditions. Our study aims to take a comprehensive perspective on hysterectomy over the years using accumulated data and provide clinicians
with an accurate insight into the hysterectomy operation.
Material-Method
This retrospective observational study was conducted on women who underwent hysterectomy at our clinic between 2012 and 2021. Comprehensive medical histories of all patients were thoroughly reviewed as the primary data. Surgical procedures were categorized and compared by year. Operation indications, preoperative endometrial sampling, and the pathology results of the final hysterectomy specimens were also examined. Risk factors were evaluated in confirmed cases of endometrial cancer and atypic endometrial hyperplasia based on pathology results. The analyses were performed using IBM SPSS 20 statistical analysis software.
Results
In our study,752 patients(mean age: 52±8.2) underwent various hysterectomy procedures, with total abdominal hysterectomy being
the most frequent(73.3%). The primary indication was uterine leiomyomas-adenomyomas(33.5%). Endometrial sampling was
performed in 57.2% of patients, showing no significant difference in reliability(p=0.143) and endometrial cancer diagnosis(p=0.334).
Among 38 patients diagnosed with endometrial cancer, approximately 28.9%(11 patients) did not undergo preoperative endometrial
sampling. Further examination revealed that these patients were obese, 63.6% presented with spotting-like bleeding, and most were
in the postmenopausal period. Risk factors for these patients and those with atypical hyperplasia indicated statistically significant
positive family history(p=0.037) and estrogen therapy history(p=0.028). Out of 536 oophorectomies, 236 were performed in women
under 50.
Conclusion
The study highlights the need to implement the current literature and promote minimally invasive approaches. Widespread adoption
of non-hysterectomy options is essential for rate reduction. Physicians must integrate current literature, refine skills in minimally invasive methods, and advance surgical techniques to achieve an idealized approach for premalignant lesions and endometrial cancer. Presenting clinic data to personalize algorithms and treatments will strengthen the literature, enhancing the field and increasing the applicability of knowledge for personalized implementation of ideal algorithms and treatments.