Are endometrial polyps true cancer precursors?

Perri, Tamar; Rahimi, Kurosh; Ramanakumar, Agnihotram V.; Wou, Karen; Pilavdzic, Dragana; Franco, Eduardo L.; Gotlieb, Walter H.; Ferenczy, Alex

doi:10.1016/j.ajog.2010.03.036

Cited by 27 publications

(26 citation statements)

References 12 publications

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“…Our fi ndings support the existence of a detection bias by which polyps would represent an enhanced detection opportunity, rather than a real endometrial cancer precursor (Perri et al 2010). As a matter of fact, endometrial pathology is extremely frequent (up to 90%) in patients with endometrial malignancy (Mittal and Da Costa 2008), and atypia is oft en found in non-polypoid endometrium (Kelly et al 2007;Rahimi et al 2009).…”

Section: Endometrial Neoplasia In Women With Polyps At Ultrasound 613supporting

confidence: 67%

“…It is still a matter of debate whether endometrial polyps are real precursors of endometrial cancer, or represent instead an enhanced detection opportunity (Perri et al 2010). Hysteroscopic polypectomy is a very common procedure, which is performed by most gynaecologists (van Dijk et al 2012), although recent guidelines do not support routine removal for all the patients (AAGL 2012).…”

Section: Endometrial Neoplasia In Women With Polyps At Ultrasound 613mentioning

confidence: 99%

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Malignant and premalignant changes in the endometrium of women with an ultrasound diagnosis of endometrial polyp

Gambadauro

Martínez-Maestre

Schneider

et al. 2014

Journal of Obstetrics and Gynaecology

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The association between polyps and endometrial cancer is under debate. The main objectives of this study were to study the frequency and the characteristics of malignant and premalignant endometrial changes in women with endometrial polyp at ultrasound. The study population consisted of 1,390 consecutive patients that were referred to office hysteroscopy because of the ultrasonographic diagnosis of endometrial polyps. A total of 16 cases of endometrial neoplasia were diagnosed (1.15%). The frequencies of atypia and cancer in our population were 0.14% and 1.01%, respectively. All patients, except one, were postmenopausal (93.8%). All had undergone the initial ultrasonographic assessment because of symptoms (bleeding in the 93.8%). The neoplasia was not confined to the polyp in 75% of the cases. Nine cases had a lower risk disease (56.25%; atypical hyperplasia or endometrial cancer stage IA-G1,2), while seven had a higher risk cancer (43.75%; ≥ stage IA-G3). Patients with a higher risk disease were found to be significantly younger, and their polyps were smaller, albeit non-significantly. In spite of the common practice to refer all women with an ultrasound diagnosis of polyp to hysteroscopy, our data show how the prevalence of endometrial neoplasia in these patients is low (1.15%). Moreover, the malignancy is not confined to a polyp in most of the cases.

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Section: Endometrial Neoplasia In Women With Polyps At Ultrasound 613supporting

confidence: 67%

Section: Endometrial Neoplasia In Women With Polyps At Ultrasound 613mentioning

confidence: 99%

Malignant and premalignant changes in the endometrium of women with an ultrasound diagnosis of endometrial polyp

Gambadauro

Martínez-Maestre

Schneider

et al. 2014

Journal of Obstetrics and Gynaecology

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“…Endometrial polyps are generally benign, but there is a known risk of malignancy that can be highly variable depending on the series of patients. Patients with risk factors such as menopause, symptoms of dysfunctional uterine bleeding, a history of endometrial hyperplasia, and large polyps, among others [2,3], can account for up to 10% of patients [4]. …”

Section: Introductionmentioning

confidence: 99%

Outpatient Hysteroscopic Polypectomy: Bipolar Energy System (Versapoint®) versus Mechanical Energy System (TRUCLEAR System®) - Preliminary Results

Pampalona

Bastos

Mancebo³

et al. 2015

Gynecol Obstet Invest

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Hypothesis: The new hysteroscopic system with mechanical energy is an effective outpatient technique for diagnosis and treatment that has certain advantages over conventional hysteroscopy in the management of endometrial polyps. Objectives: Our primary objective was to assess the total duration of hysteroscopy and polypectomy performed in an outpatient setting comparing the new mechanical energy hysteroscopy to the bipolar energy system. Our secondary objective was to compare the level of safety of both hysteroscopic techniques using the procedure success rate, the need for subsequent referral to surgery, existing complications, and comfort experienced by the patient during the procedure. Patients and Methods: This randomized controlled trial included the first 90 patients with an ultrasound diagnosis of endometrial polyp (>1 cm) who underwent an outpatient diagnostic and operative hysteroscopy at the Igualada Hospital (Barcelona) and agreed to be included in the study by signing an informed consent. Results: We obtained a 91% success rate with the TRUCLEAR System® compared to a 69% success rate with the Versapoint® system. Total operating time was 6.36 min in the TRUCLEAR System group versus 10.82 min in the Versapoint system group (p < 0.05), with a polypectomy time of 3.06 and 7.91 min, respectively (p < 0.05). There were no significant differences between the two techniques when analyzing pain using the visual analogue scale. No complications were recorded for either technique. Conclusion: The mechanical energy system presents a significant decrease in the total duration of polypectomy and hysteroscopy when performed both by experienced staff and by staff in training, resulting in higher success rates without complications with respect to conventional hysteroscopy with bipolar energy.

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“…Hileeto and colleagues reported that malignancy potential of EP increases with age and it gets higher after 65 years (Hileeto et al, 2005). On the contrary; the study of Perri et al (2010) suggests that EP is not a cancer precursor (Perri et al, 2010). In the study of Pavia et al, the risk of malignancy in EP was higher in women with postmenopausal bleeding and advanced age (Costa-Paiva et al, 2011).…”

Section: Discussionmentioning

confidence: 97%