The importance of progressive inflammation indexes in sarcoma prediction in occult uterine sarcomas detected during hysterectomy and myomectomies performed for benign indications

Objective: This study aims to determine the frequency of occult uterine sarcomas in hysterectomies and miyomectomies performed for benign indications at Akdeniz University Hospital between 2014 and 2024 and to investigate hematological and biochemical markers that may predict malignancy in the preoperative period. Materials and Methods: Patients who underwent hysterectomy or miyomectomy for benign indications but were diagnosed with uterine sarcoma after histopathological examination were included. Patients with a preoperative malignancy diagnosis were excluded. Patient files and pathology reports were retrospectively reviewed. Statistical analyses were performed using Independent Sample T-Test, Mann-Whitney U Test, Chi-Square (χ²) Test, and ROC Analysis, utilizing SPSS software. Results: • The frequency of occult uterine sarcomas was found to be consistent with international literature. • Parameters such as LDH, CA-125, systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) showed significant differences in sarcoma cases. • In the preoperative period, uterine sarcomas were not strongly suspected in most cases, and the diagnosis was confirmed postoperatively through histopathological examination. Conclusion: Current methods for predicting malignancy in the preoperative period of hysterectomies and miyomectomies performed for benign indications remain limited. Further studies on hematological and biochemical markers may contribute to the development of improved preoperative diagnostic algorithms.