title: Clinical factors and malignancy in endometrial polyps. Analysis of 1027 cases.
abstract: OBJECTIVE
  To assess the prevalence of polyps carrying a malignancy and match association between clinical factors and oncologic progression.
  
  
  METHODS
  A retrospective study (Canadian Task Force classification II-3) at a university hospital in Rome, Italy. We retrospectively analyzed data from 1027 women consecutively treated for endometrial polyps at our center in the period 2002-2011. The association of malignancy with hormonal status, tamoxifen, hypertension, symptoms, diabetes mellitus, obesity, and hormonal replacement therapy in pre- and post-menopausal women was assessed.
  
  
  RESULTS
  Mean age was 45.8±10.8 years. Benign polyps accounted for 95.8% of the total, pre-malignant for 2.67%, malignant for 1.54%. Our data showed that post-menopausal and older women (>60y) with endometrial polyps have a higher risk of developing a related endometrial cancer (OR: 3.05, 95% CI [1.54, 6.19], p<0.001 and OR: 2.8, 95% CI [1.38, 5.56], p≤0.003. Also we observed that women with AUB in the post-menopausal period displayed a risk of malignancy (OR: 31.1, 95% CI [10.3,111], p value <0.001).
  
  
  CONCLUSIONS
  Special attention should be drawn to symptomatic post-menopausal patients that appear to be at higher risk of malignancy. Symptomatic pre-menopausal women and asymptomatic post-menopausal women with polyps may be a group with intermediate-risk. These patients should undergo an individualized management plan, balancing both risks and benefits of surgical intervention after discussion with the patient.
authors.affiliation: Department of Obstetrics, Gynecology and Urology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy; Department of Obstetrics and Gynecology, Universitätsklinikum Freiburg, Freiburg i.Br., Germany. Electronic address: enzo.ricciardi@uniroma1.it.
authors.forename: Enzo
authors.initials: E
authors.lastname: Ricciardi
authors.affiliation: Department of Pathology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vecchione
authors.affiliation: Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Ferrara, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Marci
authors.affiliation: Department of Obstetrics, Gynecology and Urology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Schimberni
authors.affiliation: Department of Obstetrics, Gynecology and Urology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Frega
authors.affiliation: Department of Obstetrics, Gynecology and Urology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Maniglio
authors.affiliation: Department of Obstetrics, Gynecology and Urology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Caserta
authors.affiliation: Department of Obstetrics, Gynecology and Urology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Moscarini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D004714:Endometrial Hyperplasia / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011127:Polyps / Q000473:pathology*; D017698:Postmenopause; D011230:Precancerous Conditions / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Clinical factors; Endometrial cancer; Endometrial polyps; Hysteroscopy; Oncologic risk