Clinical factors and malignancy in endometrial polyps. Analysis of 1027 cases

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 183; pp. 121 - 124
• Main Authors: Ricciardi, Enzo, Vecchione, Andrea, Marci, Roberto, Schimberni, Mauro, Frega, Antonio, Maniglio, Paolo, Caserta, Donatella, Moscarini, Massimo
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.12.2014
• Subjects: Adult; Age Factors; Aged; Clinical factors; Endometrial cancer; Endometrial Hyperplasia - pathology; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - etiology; Endometrial Neoplasms - pathology; Endometrial polyps; Female; Humans; Hysteroscopy; Middle Aged; Obstetrics and Gynecology; Oncologic risk; Polyps - pathology; Postmenopause; Precancerous Conditions - pathology; Retrospective Studies; Risk Factors; Endometrial polyps; Hysteroscopy; Endometrial cancer; Clinical factors; Oncologic risk
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2014.10.021

Abstract Study objective To assess the prevalence of polyps carrying a malignancy and match association between clinical factors and oncologic progression. Study design A retrospective study (Canadian Task Force classification II-3) at a university hospital in Rome, Italy. We retrospectively analyzed data from 1027 women consecutively treated for endometrial polyps at our center in the period 2002–2011. The association of malignancy with hormonal status, tamoxifen, hypertension, symptoms, diabetes mellitus, obesity, and hormonal replacement therapy in pre- and post-menopausal women was assessed. Results Mean age was 45.8 ± 10.8 years. Benign polyps accounted for 95.8% of the total, pre-malignant for 2.67%, malignant for 1.54%. Our data showed that post-menopausal and older women (>60 y) with endometrial polyps have a higher risk of developing a related endometrial cancer (OR: 3.05, 95% CI [1.54, 6.19], p < 0.001 and OR: 2.8, 95% CI [1.38, 5.56], p ≤0.003. Also we observed that women with AUB in the post-menopausal period displayed a risk of malignancy (OR: 31.1, 95% CI [10.3,111], p value <0.001). Conclusion Special attention should be drawn to symptomatic post-menopausal patients that appear to be at higher risk of malignancy. Symptomatic pre-menopausal women and asymptomatic post-menopausal women with polyps may be a group with intermediate-risk. These patients should undergo an individualized management plan, balancing both risks and benefits of surgical intervention after discussion with the patient.