Incidence, Prognosis, and Management of Occult Endometrial Carcinoma After Hysterectomy for Benign Disease: A Systematic Review and Meta-Analysis

Background/Objectives: Occult endometrial carcinoma, incidentally diagnosed after hysterectomy for presumed benign disease, raises concerns regarding its incidence, the prognostic effects of minimally invasive surgery and morcellation, and subsequent management. This systematic review synthesized the available evidence and performed meta-analysis where appropriate.

Methods

PubMed, Scopus, and the Cochrane Central Register were searched using a sensitivity-tested strategy. After de-duplication and screening, 76 studies met the eligibility criteria. Incidence was pooled using a random-effects meta-analysis of proportions with the Freeman–Tukey double-arcsine transformation. Subgroup analyses examined surgical contexts, including hysterectomy for benign disease, morcellation-specific cohorts, and pelvic organ prolapse surgery. Survival and management outcomes were synthesized narratively.