Factors Associated with Malignancy in Hysteroscopically Resected Endometrial Polyps: A Systematic Review and Meta-Analysis

Sasaki, Lizandra Moura Paravidine; Andrade, Keitty Regina Cordeiro de; Figueiredo, Ana Cláudia Morais Godoy; Wanderley, Miriam da Silva; Pereira, Maúrício Gomes

doi:10.1016/j.jmig.2018.02.004

Cited by 58 publications

(44 citation statements)

References 48 publications

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“…The frequency of premalignant and malignant lesions in endometrial polyps was reported to be 3.4%, and there was high heterogeneity among the studies (I, 80.5%; P<0.05) [12]. Kilicdag et al [13] reported the prevalence of premalignancy or malignancy as 2.2% (0.5% hyperplasia with atypia and 1.7% endometrial adenocarcinoma) among the large sample size of premenopausal women (417 patients) with endometrial polyps.…”

Section: Discussionmentioning

confidence: 99%

Endometrial polyps: Is the prediction of spontaneous regression possible?

Yüksel¹,

Tuna²,

Çelik

et al. 2021

Obstet Gynecol Sci

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Objective Endometrial polyps have been considered as a hyperplastic growth of endometrial stromal and glandular tissues. Even asymptomatic polyps in premenopausal women are usually removed as soon as they are diagnosed, although it is still unknown how often endometrial polyps disappear spontaneously. The aim of this study was to investigate the regression rate of endometrial polyps and the possible factors related to their spontaneous regression. Methods A total of 197 women with endometrial polyps were treated with operative hysteroscopy between January 2017 and April 2019 at our tertiary center. Of these, 123 patients who preferred conservative follow-up were enrolled in the study. Clinical and pathological data were obtained from electronic medical records. Results Patients with endometrial polyps were followed up for a median period of 62 days (range 30–360 days). Most women with endometrial polyps (84%) were reported to have gynecologic symptoms. Spontaneous polyp regression was observed in 28 (23%) patients who underwent surgery reevaluation. Patient age (<45 years), premenopausal period, and polyp size (<2 cm) were found to be associated with spontaneous endometrial polyp regression ( P <0.05). We also observed more polyp regression in women with abnormal uterine bleeding ( P =0.05). Second-look hysteroscopy showed that all postmenopausal women had persistent endometrial polyps. Conclusion Patient age (<45 years), premenopausal period, polyp size (<2 cm), and abnormal uterine bleeding may be associated with spontaneous endometrial polyp regression.

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Section: Discussionmentioning

confidence: 99%

Endometrial polyps: Is the prediction of spontaneous regression possible?

Yüksel¹,

Tuna²,

Çelik

et al. 2021

Obstet Gynecol Sci

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“…Außerdem können Endometriumkarzinome vom Typ II innerhalb von glandulär-zystischen Korpuspolypen entstehen [33]. Eine aktuelle Metaanalyse zeigt eine Prävalenz prämaligner und maligner Läsionen in Endometriumpolypen von 3,4 % (95 %-Konfidenzintervall, 2,8-4,1) [34]. Daher sollten eine diagnostische Hysteroskopie sowie fraktionierte Abrasio und Polypabtragung zur weiteren Abklärung durchgeführt werden.…”

Section: Therapieunclassified

Management benigner und prämaligner Veränderungen der Vulva und der Zervix

Schüler-Toprak¹,

Ortmann²

2020

Frauenheilkunde up2date

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“…Further, cross-validation showed that no study exerted a big influence on the pooled prevalence estimate. Nonetheless, we were unable to identify and quantify the relevant epidemiological and clinical parameters that may predict hyperplasia and cancer in endometrial polyps, such as recurrent PMB, body mass index (BMI), hypertension, diabetes, and endometrial thickness 5,7,12 because of inconsistent or lack of reporting in various studies. This precluded further subgroup analyses and meta-regression.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…7,11,12 This makes it difficult to produce guidelines for management. Further, one randomised controlled trial (RCT) 13 and three systematic reviews 7,11,12 failed to produce evidence as regards the best management of endometrial polyps in women with PMB. The RCT was discontinued after 26 months because of lack of recruitment to the expectant management arm.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of hyperplasia and cancer in endometrial polyps in women with postmenopausal bleeding: A systematic review and meta-analysis

et al. 2019

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There is wide variation in reporting the prevalence of hyperplasia and cancer in endometrial polyps in women with postmenopausal bleeding. Most studies reported heterogenous populations of pre-and postmenopausal women both symptomatic and asymptomatic, making data interpretation difficult. The aim of this work is to quantify the prevalence of hyperplasia and cancer in polyps in women with postmenopausal bleeding aiming to produce data that help inform clinical practice as whether it is safer to remove all polyps, or some women could be offered expectant management. The search terms used were Medical Subject Headings terms, text words, truncations and word variations of the words or phrases 'endometrial polyp' or 'uterine polyp' or 'womb polyp' and 'postmenopause' or 'menopause'. Search was limited to human studies and English language articles. Studies reporting separate analysis for women with postmenopausal bleeding were included. The included articles were assessed for risk of bias using the 'Quality in Prognosis Studies' tool. The prevalence was estimated with a random effect model using 'DerSimonian and Laird' method. The pooled estimate of prevalence of hyperplasia and cancer was 9% (95% confidence interval: 6.5%-11.5%). An I 2 statistic of 77.2% suggests likely substantial heterogeneity. However, adjustment for small study effects had no influence on the pooled prevalence estimate suggesting no evidence for publication bias. Sensitivity analyses showed that no study exerted a big influence on the pooled estimate. The prevalence of hyperplasia and cancer in endometrial polyps in women with postmenopausal bleeding is high enough to warrant removal for accurate histopathological diagnosis.

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Factors Associated with Malignancy in Hysteroscopically Resected Endometrial Polyps: A Systematic Review and Meta-Analysis

Cited by 58 publications

References 48 publications

Endometrial polyps: Is the prediction of spontaneous regression possible?

Endometrial polyps: Is the prediction of spontaneous regression possible?

Management benigner und prämaligner Veränderungen der Vulva und der Zervix

Prevalence of hyperplasia and cancer in endometrial polyps in women with postmenopausal bleeding: A systematic review and meta-analysis

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