Beyond Size: The Impact of Endometrial Polyp Location on Malignancy Risk

Area of Science:

• Gynecology
• Reproductive Medicine
• Oncology

Background:

• Endometrial polyps are common, but their association with malignancy varies.
• Histopathological evaluation is crucial for diagnosis.
• Risk factors for malignant transformation require further investigation.

Purpose of the Study:

• To determine if endometrial polyp location correlates with premalignant or malignant histopathology.
• To compare clinical and morphological features of benign versus premalignant/malignant polyps.
• To identify predictors of malignancy in endometrial polyps.

Main Methods:

• Retrospective observational study of 580 women undergoing hysteroscopic polypectomy.
• Polyps categorized by hysteroscopic localization (fundal, anterior, posterior, cornual, lower uterine segment).
• Multivariate logistic regression used to analyze associations between polyp location, clinical factors, and histopathology.

Main Results:

• Premalignant/malignant pathology found in 6.4% of cases, more frequent in fundal and cornual locations.
• Malignant polyps were associated with older age, postmenopausal status, abnormal uterine bleeding, larger size, and thicker endometrium.
• Fundal (OR 2.18) and cornual (OR 2.87) localization were independent predictors of premalignant/malignant pathology.

Conclusions:

• Endometrial polyp location, specifically fundal and cornual, is an independent risk factor for premalignant/malignant pathology.
• Polyp localization can enhance risk stratification during hysteroscopic assessment.
• Further research is needed to validate these findings in prospective studies.