How often are endometrial polyps malignant in asymptomatic postmenopausal women? : A multicenter study
Articolo
Data di Pubblicazione:
2009
Citazione:
How often are endometrial polyps malignant in asymptomatic postmenopausal women? : A multicenter study / E. Ferrazzi, E. Zupi, F. Leone, L. Savelli, U. Omodei, M. Moscarini, M. Barbieri, G. Cammareri, G. Capobianco, E. Cicinelli, M. E. Coccia, G. Donarini, S. Fiore, P. Litta, M. Sideri, E. Solima, D. Spazzini, A. C. Testa, M. Vignali. - In: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY. - ISSN 0002-9378. - 200:3(2009), pp. 235.e1-235.e6. [10.1016/j.ajog.2008.09.876]
Abstract:
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 hyper plastic 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.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
asymptomatic endometrial polyps; endometrial cancer; hysteroscopy; polypectomy
Elenco autori:
E. Ferrazzi, E. Zupi, F. Leone, L. Savelli, U. Omodei, M. Moscarini, M. Barbieri, G. Cammareri, G. Capobianco, E. Cicinelli, M. E. Coccia, G. Donarini, S. Fiore, P. Litta, M. Sideri, E. Solima, D. Spazzini, A. C. Testa, M. Vignali
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