Gynecologic and Obstetric Investigation最新文献

{"title":"METTL14 Promotes Proliferation, Migration, and Invasion in Endometriotic Stromal Cell Growth by Activating the ZEB1/MEK/ERK Pathway.","authors":"Xuan Lv, Fang Li","doi":"10.1159/000539656","DOIUrl":"10.1159/000539656","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to explore the mechanism of methyltransferase-like 14 (METTL14) on human endometriotic stromal cell (ESC; HEM15A) proliferation, migration, and invasion to provide novel therapy for endometriosis (EMs).</p><p><strong>Design: </strong>Normal human endometrial stromal cells (HESCs) and HEM15A cells were selected. Corresponding controlled experiments were performed to analyze whether overexpression of METTL14, N6-methyladenosine (m6A) methylated ZEB1 mRNA, upregulation of ZEB1, and activating the mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase (ERK) can affect the proliferation, migration, and invasion of HEM15A cells. Materials, Setting, and Methods: HEM15A and HESCs were cultured in vitro. HEM15A cells were treated with oe-METTL14 and oe-zinc finger E-box-binding protein 1 (ZEB1) plasmids, 3-deazaadenosine (3-DAA) and the MEK/ERK pathway inhibitor isoprenaline (ISO). After identifying HEM15A and HESCs, METTL14, ZEB1, p-ERK1/2/ERK1/2, and p-MEK/MEK levels, and cell proliferation, migration, and invasion were assessed. The modification sites of ZEB1 and m6A were predicted using SRAMP database, with an m6A modification level assessed by MeRIP. The binding of YT521-B homology domain 2 (YTHDF2) to ZEB1 messenger RNA (mRNA), and ZEB1 stability and mRNA level were tested.</p><p><strong>Results: </strong>Compared with HESCs, METTL14 level in HEM15A was significantly reduced. METTL14 overexpression in HEM15A prominently increased its proliferation, migration, and invasion. METTL14 overexpression notably elevated m6A-methylated ZEB1 mRNA level and reduced the stability and expression of ZEB1 mRNA. Further m6A modification inhibition increased ZEB1 mRNA stability and mRNA and protein levels and decreased ZEB1 m6A modification level. ZEB1 upregulation partially reversed METTL14 overexpression-inhibited HEM15A proliferation, migration, and invasion. METTL14 inhibited the MEK/ERK signaling activation by regulating ZEB1, and the MEK/ERK signaling activation partly averted METTL14-suppressed proliferation, migration, and invasion.</p><p><strong>Limitations: </strong>The effects of METTL14 on other growth aspects of HEM15A cells and the relation between ZEB1 and m6A require further investigation.</p><p><strong>Conclusions: </strong>METTL14 lowered ZEB1 expression by regulating ZEB1 m6A modification levels, thereby inhibiting the activation of the MEK/ERK pathway and ESC proliferation, migration, and invasion.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"42-54"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Mechanical Bowel Preparation before Robot-Assisted Laparoscopic Gynecologic Surgery: A Randomized, Single-Blind, Controlled Trial.","authors":"Hyonjee Yoon, Jung Hyun Park, Jisu Mun, Youngjae Yoon, Jin-Ju Lee, Minji Ko, Hyun-Hee Cho, Jeong Namkung","doi":"10.1159/000541095","DOIUrl":"10.1159/000541095","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this randomized controlled trial was to compare the effect of bowel preparation using only oral polyethylene glycol electrolyte (PEG) solution versus oral PEG solution combined with mechanical sodium phosphate (NaP) enema on the surgical field visualization in patients undergoing robot-assisted laparoscopic gynecologic procedures.</p><p><strong>Methods: </strong>Participants were randomized to either a single oral PEG solution or an oral PEG solution combined by mechanical NaP enema. The intraoperative visualization of the surgical field, the ease of manipulation of the bowels, and overall difficulty level of the surgery were evaluated by the surgeon using a self-administered questionnaire. After the surgery, the patients completed a survey assessing postoperative gastrointestinal discomfort.</p><p><strong>Results: </strong>A total of 114 women were enrolled and randomized to oral PEG solution-only group (n = 48), and oral PEG plus mechanical NaP enema group (n = 66). Forty-two women in oral PEG-only group and 59 oral PEG plus NaP enema group completed the study. There was no difference in intraoperative visualization or overall difficulty of the operation between the two groups, and bowel manipulation was easier in the oral PEG-only group. Also, there was no difference in operating time between the groups. The patients' level of gastrointestinal discomfort after the surgery was not significantly different between the two groups.</p><p><strong>Conclusion: </strong>Routine use of mechanical NaP enema before robot-assisted laparoscopic gynecologic surgery is not recommended, because it has no additional benefit regarding intraoperative visualization or the surgical level of difficulty over oral bowel preparation methods.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"93-99"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometriosis, Anxiety, and Atherosclerosis: A Study of Eight Million Young Hospitalized Women in the USA.","authors":"Hormoz Nassiri Kigloo, Eva Suarthana, Tina Montreuil, Togas Tulandi","doi":"10.1159/000542049","DOIUrl":"10.1159/000542049","url":null,"abstract":"<p><strong>Objective: </strong>In recent years, several studies have proposed an association between endometriosis and various cardiovascular diseases. Our study evaluated the association between endometriosis and atherosclerosis in patients under 35 years of age using a large population database.</p><p><strong>Design: </strong>This was a cross-sectional retrospective population-based study.</p><p><strong>Participants/materials, setting, methods: </strong>We used the data of more than eight million hospitalized women under 35 years of age who were registered in one of the hospitals participating in the Healthcare Cost and Utilization Project - National Inpatient Sample (HCUP NIS) during the study period of 2007-2014. The prevalence of endometriosis, atherosclerosis, and related conditions was estimated, and logistic regression model was used to examine the association.</p><p><strong>Results: </strong>In the period of study of 8,061,754 patients, we noted an upward pattern for the prevalence of atherosclerosis and a downward trend for endometriosis. Adjusting the analysis for sociodemographic characteristics and comorbidities, the probability of being diagnosed with atherosclerosis was 42% higher in patients with endometriosis (odds ratio [OR] = 1.421; 95% confidence interval [CI]: 1.058-1.910); 35% higher in patients with anxiety (OR = 1.352; 95% CI: 1.249-1.464); and three times higher in women with both endometriosis and anxiety (OR = 3.075; 95% CI: 1.969-4.803) compared to women without those conditions.</p><p><strong>Limitations: </strong>In HCUP NIS databases, some information such as the severity of disease, laboratory findings, or medical treatment is not available.</p><p><strong>Conclusion: </strong>The strong association between endometriosis and atherosclerosis suggests that they may share a similar mechanism possibly endothelial dysfunction related to chronic inflammation. Further studies on the potential role of psychological conditions, such as anxiety, on systemic inflammatory diseases are also deemed timely and important.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"194-201"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Ultrasound Features of Normocyclic Non-Hyperandrogenic Adolescents in Early Gynecological Life.","authors":"Anna Maria Fulghesu, Stefano Di Michele, Ilaria Zangaris, Martina Cordella, Elena Pittui, Giulia Scalise, Salvatore Giovanni Vitale, Stefano Angioni","doi":"10.1159/000542393","DOIUrl":"10.1159/000542393","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the prevalence of polycystic ovarian morphology (PCOM) in healthy postmenarcheal girls and assess whether it represents a crucial physiological phase in gynecological development. Additionally, it evaluated if an elevated stromal-to-surface area (S/A) ratio could identify individuals at risk of developing polycystic ovarian syndrome (PCOS).</p><p><strong>Design: </strong>This is an observational cross-sectional study.</p><p><strong>Participants: </strong>A total of 302 healthy postmenarcheal girls aged 14-18 were included in the study.</p><p><strong>Setting: </strong>The study was conducted at the Pediatric and Adolescent Gynecology Service of the University Hospital Duilio Casula, Monserrato, University of Cagliari, from 2020 to 2023.</p><p><strong>Methods: </strong>Participants were divided into three groups: normal ovarian morphology (NOM), PCOM with normal S/A ratio (PCOM-NS), and PCOM with increased S/A ratio (PCOM-IS). Anthropometric, clinical, hormonal, and ultrasound (US) characteristics were analyzed.</p><p><strong>Results: </strong>The overall prevalence of PCOM was 43% (95% CI: 0.37-0.49). Among 302 subjects, 171 (57%) exhibited NOM, 90 (30%) showed PCOM-NS, and 41 (13%) had PCOM-IS. The age and years of postmenarcheal life were significantly lower in the PCOM-NS group than in the NOM group. PCOM-NS exhibited a higher waist-to-hip ratio, hirsutism prevalence, and follicle count per ovarian section. PCOM-IS was associated with elevated androgen levels. A significant reduction in the PCOM pattern was observed after the third postmenarcheal year, while the NOM pattern increased significantly beyond 5 years postmenarche.</p><p><strong>Limitations: </strong>The study is limited by its cross-sectional design, which precludes establishing causality. Additionally, the exclusion of certain participants due to technical limitations in US evaluation may introduce selection bias.</p><p><strong>Conclusions: </strong>PCOM may represent a normal physiological phase in ovarian development during early adolescence, predominantly observed in the first 1-3 years postmenarche. An increased S/A ratio could help identify adolescents who may benefit from monitoring for potential PCOS development.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"296-304"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assisted Reproductive Technology, Pregnancy, and Recurrent Disease in Melanoma Patients: A 30-Year Single Institution Experience.","authors":"Sander Kelderman, Jorine de Haan, Dachmar Rhijnsburger, Abigael Bouwman, Christianne De Groot, John Haanen, John Coulter, Winan Van Houdt, Frédéric Amant, Christianne Lok","doi":"10.1159/000541566","DOIUrl":"10.1159/000541566","url":null,"abstract":"<p><strong>Objectives: </strong>The primary aim of this study was to assess differences in melanoma recurrence between patients conceiving spontaneously versus those undergoing assisted reproductive technology (ART) and to determine use of ART in post-melanoma patients. A secondary aim was to describe the use of immunotherapy as a novel treatment regimen for metastatic melanoma in a cohort of fertile patients.</p><p><strong>Design: </strong>This study is a 30-year analysis including data from a single-center questionnaire and a retrospective cohort study. Participants/Materials: Women of childbearing age with a history of melanoma were requested to participate in our study. We selected patients who underwent either primary melanoma treatment or treatment of local/distant recurrence at our institute between 1994 and 2021. Each participant received a questionnaire and informed consent form. The questions concerned general health, primary tumor characteristics, utilization of ART, subsequent pregnancies, and development of recurrent melanoma. Additional information was collected from the medical files.</p><p><strong>Setting: </strong>The research was conducted in a dedicated oncology center and tertiary referral center for melanoma in The Netherlands.</p><p><strong>Methods: </strong>Participants received the questionnaires by mail. Six weeks later a reminder was sent to nonresponders. Analysis was performed using descriptive statistics. For comparisons between groups, chi-square tests were used. p value was considered significant when below 0.05. A clinically relevant difference in recurrence rate was defined as a 10% difference.</p><p><strong>Results: </strong>A total of 498 questionnaires were available for analyses, 449 from living patients and 49 from relatives of diseased patients. One hundred and seventy-nine patients (36%) with a history of melanoma became pregnant following their diagnosis. There was no difference in the recurrence rate between patients who became pregnant after the diagnosis of melanoma and those who never subsequently conceived (37% vs. 35%, p = 0.609). In the total cohort, 28 patients (6%) attempted to conceive using ART, and eight of them experienced disease recurrence. A total of 58 patients (22% of patients since 2006) were treated with immunotherapy.</p><p><strong>Limitations: </strong>The main limitations of the study are its size, observational design, and questionnaire methodology.</p><p><strong>Conclusions: </strong>Pregnancy did not increase the risk of recurrent melanoma. The group of patients conceiving after ART was small, and therefore, it is difficult to confidently conclude that the recurrence risk is comparable to the other groups. Prospective international registration of these patients, their oncologic follow-up and possible use of assisted reproduction, will provide valuable information to determine any potential association between ART and risk of recurrent melanoma. This would enable health profession","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"165-172"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, Regional, and National Prevalence and Disability-Adjusted Life-Years for Female Infertility: Results from a Global Burden of Disease Study, 1990-2019.","authors":"DongYi Shen, Sen Yang, Cong Qi, Hong Yang","doi":"10.1159/000542408","DOIUrl":"10.1159/000542408","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to determine the prevalence of female infertility in 204 countries and territories from 1990 to 2019.</p><p><strong>Design: </strong>We evaluated the female infertility global burden between 1990 and 2019 in this systematic study.</p><p><strong>Materials: </strong>The Global Health Data Exchange query tool (http://ghdx.healthdata.org/gbd-results-tool) and sociodemographic index (SDI) (http://ghdx.healthdata.org/data-type/estimate) provided data on the annual prevalence numbers, age-standardized prevalence rates (ASR), and disability-adjusted life-years (DALYs) of female infertility in 204 countries and territories from 1990 to 2019 for various age groups.</p><p><strong>Setting: </strong>Female infertility has a devastating impact on the physical and mental health of individuals and national fertility. However, most of the previous studies on this subject were conducted on rather small sample sizes and have certain limitations.</p><p><strong>Methods: </strong>We examined female infertility in terms of prevalence, ASR, and DALYs across different age groups in 204 countries and territories from 1990 to 2019 using data from the Global Health Data Exchange query tool.</p><p><strong>Results: </strong>From 1990 to 2019, ASR and DALYs for female infertility increased globally. At the SDI quintile level, middle-SDI and high-middle-SDI countries exhibited a faster increase in the ASR of female infertility. In 2019, with the highest female infertility rate recorded among those between the ages of 30-34 years and the lowest among those between the ages of 45-49 years. In 2019, high-income North America recorded the highest proportion of primary infertility, while East Asia recorded the lowest proportion.</p><p><strong>Limitations: </strong>First, the global burden of disease (GBD) database lacks data for some countries and regions. Second, data access and quality differ across locations. Third, the causes of infertility are not comprehensive, and data on Klinefelter in GBD 2019 in relation to primary infertility were absent.</p><p><strong>Conclusion: </strong>Globally, the prevalence of DALYs and age-standardized female infertility rates increased from 1990 to 2019.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"279-295"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Statement.","authors":"","doi":"10.1159/000543019","DOIUrl":"10.1159/000543019","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"182"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.1159/000546453","DOIUrl":"10.1159/000546453","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"382"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Diagnostic Reliability of Intraoperative Frozen Section in the Surgical Management of Early-Stage Cervical Cancer.","authors":"Sarah Louise Smyth, Edward Jackson, Negin Sadeghi, Christina Pappa, Nahid Ghanbarzadeh, Ciro Pinelli, Pathiraja Pubudu, Sunanda Dhar, Zoe Traill, Pietro Serra, Antonio Simone Laganà, Moiad Alazzam","doi":"10.1159/000541096","DOIUrl":"10.1159/000541096","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study of this study was to evaluate preoperative radiology and histopathology findings in cervical cancer lymphadenopathy detection, allowing targeted frozen section examination (FSE).</p><p><strong>Design: </strong>A retrospective analysis was conducted of 203 early-stage cervical cancer patients between 2010 and 2019 in a tertiary centre.</p><p><strong>Participants/materials, setting, and methods: </strong>All patients had histologically confirmed cervical cancer and underwent magnetic resonance imaging (MRI) prior to intraoperative FSE. The primary objectives of the study were to determine the diagnostic accuracy of intraoperative FSE in the identification of lymph node metastases (LNM) in early-stage cervical cancer by correlation with final results obtained using standard histopathology techniques and to examine different preoperative, intraoperative, demographic, radiological, and histopathological factors that could identify those at greatest risk of nodal disease and hence predict those most likely to benefit from FSE, enabling more selective and targeted use.</p><p><strong>Results: </strong>Nineteen patients were found to have LNM (9.36%) at FSE. Patients were at increased risk of LNM by 6-fold with positive LVSI, 3-fold with MRI lymphadenopathy, and 3.5-fold with MRI-visible disease. The presence of lymphadenopathy on MRI and positive LVSI in combination increased the risk of LNM by 19-fold.</p><p><strong>Limitations: </strong>We acknowledge that FSE is expensive and time intensive, exposing patients to increased surgery duration and associated risk. We also recognize that it may not be feasible for all patients. Finally, the analysis is limited by retrospective nature of the study.</p><p><strong>Conclusions: </strong>By application of the preoperative risk stratification algorithm, we may suggest that FSE can be a useful tool in high-risk patients.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"64-77"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Occult Malignancy in Women Undergoing Hysterectomy or Myomectomy for Benign Indications and the Impact of Morcellation on Survival Outcomes: A Meta-Analysis.","authors":"Dan Jiang, Hongxuan Liu, Kui Huang, Yan Chen, Qiao Liu, Chuqiang Shu, Qi Tian","doi":"10.1159/000542894","DOIUrl":"10.1159/000542894","url":null,"abstract":"<p><strong>Introduction: </strong>Uterine fibroids (UFs), also known as leiomyomas, are the most common benign gynecological tumors. Currently, morcellation is discouraged due to the risk of disseminating undetected malignancies. This study aimed to update the prevalence data on occult malignancies in surgeries for suspected benign uterine lesions and analyze the impact of treatment strategies on the survival outcomes in patients with occult malignancy.</p><p><strong>Methods: </strong>Five English-language literature databases were systematically searched up to July 25, 2024, for studies reporting the incidence of occult malignancies in patients with suspected UFs and their survival outcomes. The study was preregistered on PROSPERO (CRD42024580233).</p><p><strong>Results: </strong>A total of 34 studies were included in the analysis. The pooled incidence of occult malignancies, calculated using a random-effects model, was 2.88 (2.10-3.94) per 1,000 individuals. Significant regional variations were observed in the subgroup comparisons (p < 0.01). Morcellation did not significantly affect progression-free survival (PFS) (hazard ratio [HR]: 1.26, 95% confidence interval [CI]: 0.86-1.84, p = 0.240) or overall survival (OS) (HR: 1.13, 95% CI: 0.70-1.82, p = 0.614). Pooled analysis of HR revealed that chemotherapy significantly improved PFS (HR: 0.49; 95% CI: 0.32-0.77; p = 0.002) and OS (HR: 0.49; 95% CI: 0.28-0.87; p = 0.015).</p><p><strong>Conclusions: </strong>The incidence of occult malignancies in women undergoing hysterectomy or myomectomy for benign conditions is approximately 2.88 per 1,000 individuals. Morcellation does not impact survival outcomes, whereas adjuvant chemotherapy provides a survival benefit. Further well-designed clinical trials are required to validate these findings.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"328-341"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}