Background: Currently, determining the postoperative recurrence of endometrial polyps is an unresolved issue, so we screened the risk factors to establish a nomogram for clinical practice.
Methods: From January 2012 to June 2020, 133 patients who underwent hysteroscopic endometrial polypectomy and diagnostic curettage due to suspicious endometrial polyps for the first time and were pathologically diagnosed as endometrial polyps after surgery. All patients were followed up for more than 12 months, and 9 (6.77%) cases were lost to follow-up. Logistic regression analysis of clinical factors was performed to screen independent risk factors and construct a column chart to predict the probability of adverse events. The fitting curve was used to validate the line graph.
Results: The ratio of patients with body mass index (BMI) <28 kg/m2 in the recurrence group was lower than in the non-recurrence group (P=0.028), as was the proportion of patients with polyp <2 cm (recurrence group vs. non-recurrence group, P=0.027) and the proportion of patients in the recurrence group treated with progesterone after surgery compared with non-recurrence group (P=0.003). However, the proportion of endometrial thickening in the recurrence group was higher than in the non-recurrence group (P=0.006). Age, BMI, polyp size, and endometrial thickening were independent risk factors for recurrence after endometrial polypectomy [odds ratio (OR) >1, P<0.05]. Progesterone therapy after surgery was an independent protective factor for recurrence after endometrial polypectomy (OR <1, P<0.05). Our nomogram was based on age, BMI, polyp size, endometrial thickening, and postoperative progesterone treatment. The maximum offset between the predicted curve and the ideal curve was 0.083, and the minimum offset between the model and the ideal model was 0.021. The height of the linear curve was close to that of the ideal curve. The U test showed P=0.898, greater than 0.05, indicating that the nomogram model passed the calibration test. The receiver operating characteristic curve was 0.886.
Conclusions: Our nomogram based on age, BMI, polyp size, progesterone treatment, and endometrial thickening accurately predicted the risk of polyp recurrence after endometrial polypectomy and can be applied in clinical practice.
Keywords: Calibration curves; endometrial polyps; nomograms; recurrence.