How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study - 13/08/11

Doi : 10.1016/j.ajog.2008.09.876

Enrico Ferrazzi, MD ^a, Errico Zupi, MD ^b, Francesco P. Leone, MD ^a, Luca Savelli, MD ^c, Umberto Omodei, MD ^d, Massimo Moscarini, MD ^e, Maurizio Barbieri, MD ^f, Giuseppe Cammareri, MD ^g, Giampiero Capobianco, MD ^h, Ettore Cicinelli, MD ⁱ, Maria E. Coccia, MD ^j, Gloria Donarini, MD ^d, Simona Fiore, MD ^a, Paolo Litta, MD ^k, Mario Sideri, MD ^l, Eugenio Solima, MD ^m, Donata Spazzini, MD ⁿ, Antonia C. Testa, MD ^o, Massimo Vignali, MD ^p
^a Department of Obstetrics and Gynecology, DSC L. Sacco, University of Milan, Milan, Italy
^b Department of Surgery, Obstetrics, and Gynecology Unit, University of Rome “Tor Vergata,” Rome, Italy
^c Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy
^d Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy
^e Department of Obsterics and Gynecology, University of Rome “Sapienza,” Roma, Italy
^f Department of Obstetrics, Gynecology, and Neonatology, “Policlinico-Mangiagalli-Regina Elena” Foundation, Milan, Italy
^g Department of Obstetrics and Gynecology, Ospedale V. Buzzi, Milan, Italy
^h Department of Pharmacology, Gynecology, and Obstetrics, University of Sassari, Sassari, Italy
ⁱ Department of Obstetrics and Gynecology, University of Bari, Bari, Italy
^j Department of Gynecology, Perinatology, and Human Reproduction, University of Florence, Florence, Italy
^k Department of Gynecological Science and Human Reproduction, University of Padua, Padua, Italy
^l Division of Gynecology, European Institute of Oncology, Milan, Italy
^m Department of Gynecologic Oncology, Istituto Nazionale Tumori, Milan, Italy
ⁿ Department of Obstetrics and Gynecology, Ospedali Riuniti di Bergamo, Bergamo, Italy
^o Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy
^p Department of Obstetrics and Gynecology, Macedonio Melloni Hospital, University of Milan, Milan, Italy

Résumé

Objective

The objective of the study was to evaluate the prevalence of cancer and premalignant lesions in polyps on atrophic endometrium in asymptomatic postmenopausal women to compare these findings with a similar cohort of patients with abnormal uterine bleeding.

Study Design

One thousand one hundred fifty-two asymptomatic and 770 consecutive postmenopausal women with abnormal uterine bleeding were included in a retrospective multicenter study. Recruited patients underwent hysteroscopic polypectomy based on a sonohysterographic or hysteroscopic diagnosis. The pathologic report was the main outcome measure.

Results

One single case of stage 1 grade 1 endometrial carcinoma on a polyp with a mean diameter of 40 mm (0.1%) was observed in asymptomatic women. This prevalence was 10 times lower than in symptomatic patients (P < .0001). The prevalence of atypical hyperplastic polyps was 1.2% in asymptomatic women (2.2% in symptomatic patients; P < .005). At multivariate analysis, polyps' diameter was the only variable significantly associated to an abnormal histology (cancer, polypoid cancer, and atypical hyperplasia) in asymptomatic women (odds ratio for polyps with mean diameter > 18 mm, 6.9; confidence interval, 2.2-21.4).

Conclusion

Follow-up and/or treatment of endometrial polyps incidentally diagnosed in asymptomatic postmenopausal patients could be safely restricted to few selected cases based on polyp diameter.

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Key words : asymptomatic endometrial polyps, endometrial cancer, hysteroscopy, polypectomy

Plan

Materials and Methods

	Cite this article as: Ferrazzi E, Zupi E, Leone FP, et al. How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study. Am J Obstet Gynecol 2009;200:235.e1-235.e6.
	Reprints not available from the authors.

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Vol 200 - N° 3

P. 235.e1-235.e6 - mars 2009 Retour au numéro

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How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study - 13/08/11

Résumé

Objective

Study Design

Results

Conclusion

Plan

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