7868 The Incidence of Endometrial Carcinoma in Patients with Atypical Endometrial Hyperplasia Versus Atypical Endometrial Polyp

Abstract

<h3>Study Objective</h3> To compare the incidence of endometrial carcinoma following hysterectomy in patients with presurgical diagnosis of EIN (endometrial intraepithelial neoplasia) of the endometrium versus EIN confined to endometrial polyp. <h3>Design</h3> Retrospective cohort study. <h3>Setting</h3> Tertiary university-affiliated hospital. <h3>Patients or Participants</h3> Eighty-eight women included in the study, of those, 50 women were diagnosed with EIN confined to a polyp (endometrial polyp group) and 38 women had endometrial EIN following endometrial biopsy (non-polypoid group). <h3>Interventions</h3> Medical records of women who underwent staging surgery for endometrial EIN or EIN confined to a polyp between 2014 and 2020 were reviewed. <h3>Measurements and Main Results</h3> The mean age at diagnosis was 60.2 ± 9.9 years in the endometrial polyp group as compared to 61.7 ± 12 years in the non-polypoid group (p=0.5). Eighty-nine percent of the women in the non-polypoid group presented with abnormal uterine bleeding (post/perimenopausal) whereas 46% of the women in the endometrial polyp group were asymptomatic (p=0.001). Pathology results following hysterectomy revealed concurrent endometrial carcinoma in 26% of women in the endometrial polyp group compared to 47% of women in the non-polypoid group (p=0.001). Eighty-four percent of cancers were grade-1 in the endometrial polyp group compared to 50% in the non-polypoid group(p=0.048). Only one patient in the non-polypoid group (5.6%) had lymph node involvement. <h3>Conclusion</h3> Concurrent cancer is less frequent with atypical endometrial polyp as compared to atypical endometrial hyperplasia. Still, the high incidence of endometrial carcinoma in both groups supports the current advice to perform hysterectomy and bilateral salpingo-oophorectomy for peri and post-menopausal women. Our data does not support performing sentinel lymph node dissection for EIN.