Endometrial polyps: when to resect?

作者：da Rocha de Azevedo Julia Marques; da Rocha de Azevedo Ligia Marques; Freitas Fernando; Osorio Wender Maria Celeste

来源：Archives of Gynecology and Obstetrics, 2016, 293(3): 639-643.

DOI：10.1007/s00404-015-3854-3

• Endometrial polyps
• Hysteroscopy
• Malignancy
• Menopause
• Uterine bleeding

Purpose To determine the prevalence of malignant and premalignant endometrial polyps and to investigate the association of malignancy with specific factors.
Methods This is a retrospective study of women submitted to hysteroscopic resection of endometrial polyps between January 2005 and July 2013 at a university hospital in southern Brazil. Data regarding clinical characteristics and pathology findings were collected from patient charts.
Results Of 359 patients, 87.2 % had benign polyps and 9.9 % had hyperplasia without atypia. Atypical hyperplasia was found in 2.6 % of the sample. Endometrial adenocarcinoma was found in one woman (0.3 %). A correlation was observed between malignant/premalignant polyps and patient age, menopausal status, and uterine bleeding. All patients with malignancies/premalignancies had abnormal uterine bleeding. Higher frequency of malignant polyps was observed in tamoxifen users, however, without statistical significance (p = 0.059 %). Malignancy was not correlated with arterial hypertension, diabetes mellitus, obesity, hormone therapy, endometrial thickness, and polyp diameter.
Conclusions Malignant/premalignant findings had low prevalence and were absent in asymptomatic patients. From the data of this retrospective study, it is unclear whether routine polypectomy should be performed in asymptomatic patients. Further prospective studies including larger numbers of patients are required to guide treatment recommendations.

• 出版日期2016-3