Ahmet Namazov1, Limor Helpman2, Ram Eitan3, Zvi Vaknin4, Ofer Lavie5, Alon Ben-Arie6, Amnon Amit7, Tally Levy8, Michael Volodarsky9, Ilan Atlas10, Ilan Bruchim11, Ofer Gemer9. 1. Barzilai University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Ashkelon. Electronic address: enamazov@gmail.com. 2. Meir Medical Center, Clalit Health Services, Tel Aviv University, Kfar Saba. 3. Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Petah Tikva. 4. Assaf Haroffe Medical Center, Sackler School of Medicine, Tel Aviv University, Zrifin. 5. Carmel Medical Center, Rappaport Faculty of Medicine, Technion, Haifa. 6. Kaplan Medical Center, Hebrew University, Rehovot. 7. Rambam Medical Center, Rappaport Faculty of Medicine, Technion, Haifa. 8. Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Holon. 9. Barzilai University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Ashkelon. 10. Poriya Medical Center, Bar Ilan University, Tiberia. 11. Hillel Yaffe Medical Center, Rappaport Faculty of Medicine, Technion, Hedera.
Abstract
OBJECTIVE: To compare outcomes of symptomatic and asymptomatic women with endometrial cancer and a preoperative diagnosis of an endometrial polyp. DESIGN: An Israel Gynecologic Oncology Group multi-center retrospective cohort study. METHODS: Of 635 patients with endometrial cancer and a preoperative diagnosis of an endometrial polyp who underwent surgery between 2002 and 2014 in one of 11 centers in Israel were divided into two groups according to the presence of bleeding symptoms. Outcome measures included recurrence-free survival, disease-specific survival and overall survival. Survival data were plotted according to the method of Kaplan and Meier and compared using the log-rank test. RESULTS: There were 513 symptomatic and 122 asymptomatic women with endometrial cancer and a preoperative diagnosis of an endometrial polyp. The median follow-up was 52 months (range 12-120 months). There were no differences between patients who experienced bleeding and those who did not in 5-year recurrence-free survival (85.2 % vs. 85.7 %; p=0.83, respectively), disease-specific survival (88.2 % vs. 89.2 %; p=0.71, respectively), or overall survival (80.2% vs. 78.4 %; p=0.97, respectively). CONCLUSION: The diagnosis of endometrial cancer in patients with asymptomatic endometrial polyps is not associated with improved outcomes as compared with patients with bleeding. In the absence of factors indicating a high risk of endometrial cancer, clinical and sonographic follow-up is the advised management strategy for these patients.
OBJECTIVE: To compare outcomes of symptomatic and asymptomatic women with endometrial cancer and a preoperative diagnosis of an endometrial polyp. DESIGN: An Israel Gynecologic Oncology Group multi-center retrospective cohort study. METHODS: Of 635 patients with endometrial cancer and a preoperative diagnosis of an endometrial polyp who underwent surgery between 2002 and 2014 in one of 11 centers in Israel were divided into two groups according to the presence of bleeding symptoms. Outcome measures included recurrence-free survival, disease-specific survival and overall survival. Survival data were plotted according to the method of Kaplan and Meier and compared using the log-rank test. RESULTS: There were 513 symptomatic and 122 asymptomatic women with endometrial cancer and a preoperative diagnosis of an endometrial polyp. The median follow-up was 52 months (range 12-120 months). There were no differences between patients who experienced bleeding and those who did not in 5-year recurrence-free survival (85.2 % vs. 85.7 %; p=0.83, respectively), disease-specific survival (88.2 % vs. 89.2 %; p=0.71, respectively), or overall survival (80.2% vs. 78.4 %; p=0.97, respectively). CONCLUSION: The diagnosis of endometrial cancer in patients with asymptomatic endometrial polyps is not associated with improved outcomes as compared with patients with bleeding. In the absence of factors indicating a high risk of endometrial cancer, clinical and sonographic follow-up is the advised management strategy for these patients.