The incidence of unexpected uterine malignancy in women undergoing hysteroscopic myomectomy or polypectomy: A national population-based study

Abstract

ObjectiveThe objective of this study was to investigate the incidence of unexpected uterine malignancy (UUM) diagnosed after hysteroscopic surgery for presumed submucosal leiomyomas or endometrial polyps. Study designFrom the Korean national health insurance database between January 1, 2009 and December 31, 2015, we analyzed inpatient sample data that were extracted by a stratified random sampling (gender and age) method. We extracted women with or without UUM that was diagnosed after hysteroscopic surgery using diagnosis codes and procedure codes. ResultsA total of 11,866 women who underwent hysteroscopic surgery were extracted from 4,476,495 women. The mean age of the patients who underwent hysteroscopic surgery was 37.8 ± 0.1 years. A hysteroscopic myomectomy or polypectomy was performed in 3498 and 8368 women, respectively. The incidence of UUM diagnosed after hysteroscopic myomectomy or polypectomy was 0.86% and 1.11%, respectively. The logistic regression analysis showed that the risk of UUM increased with age (Odds Ratio (OR), 1.61; 95% Confidence Interval (CI), 1.47–1.77; P < 0.001) and did not indicate hysteroscopic myomectomy or polypectomy (OR, 1.21; 95% CI, 0.93–1.55; P = 0.151). ConclusionsThe incidence of UUM diagnosed after hysteroscopic myomectomy (0.86%) or polypectomy (1.11%) was higher than that of UUM diagnosed after hysterectomy (0.19%) or myomectomy (0.12%) for presumed benign leiomyoma. The incidence of UUM increased over the age of 50.