Current status of the problem of diagnostics in operative gynecology: emphasis on oncopathology

Abstract

Providing surgical care to women with tumors of the genital organs requires reliable diagnostics, which is crucial for timely and adequate treatment of both benign and malignant diseases.

Aim - to perform a study of the frequency of malignant neoplasms of the female genital organs among patients operated from 2020 to 2025 for the optimization of perioperative diagnosis.

Materials and methods. A total of 4393 patients were included in the study, who underwent surgery from January 2020 to October 2025. All women involved in the work were divided into clinical groups according to the year of treatment. 619 patients were included in group I (treated surgically in 2020). There were 605 women in group II (2021). There were 718 women in group III (2022). There were 1522 patients in group IV (2023). Group V (2024) combined 1122 observations of operated women. Group VI (January-October 2025) included 1002 patients. All available data from the hospital automated system were analyzed, including passport, anamnesis, objective examination, instrumental and laboratory indicators, surgical interventions, and results of pathomorphological studies.

Results. The uterine adenocarcinoma was the most frequently diagnosed malignant pathology throughout the entire period of 2020-2025. The malignant neoplasms were “mimicked” as other benign pathologies. We recorded an extremely low sensitivity (25.5%) of cancer diagnostics. In 74.5% of cases, oncopathology was detected accidentally during histological examination of a biopsy. At the same time, high specificity (almost 100%) was noted. The preliminary suspicion of malignancy was almost always supported via histology.

Conclusions. Traditional preoperative methods are often unable to distinguish complex adenocarcinomas from ordinary polyps or hyperplasia. This confirms that pathohistological examination of material obtained during “minor” operations (hysteroscopy, curettage, polypectomy) is a critically important stage that corrects errors in the primary diagnosis.

No conflict of interests was declared by the authors.