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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2016

01-03-2016 | Gynecologic Oncology

Tumor Characteristics and Survival Outcome of Endometrial Cancer Arising in Adenomyosis: An Exploratory Analysis

Authors: Koji Matsuo, MD, PhD, Aida Moeini, MD, Hiroko Machida, MD, Christopher A. Scannell, PhD, Jennifer K. Casabar, BS, Mamoru Kakuda, MD, Sosuke Adachi, MD, PhD, Jocelyn Garcia-Sayre, MD, Yutaka Ueda, MD, PhD, Lynda D. Roman, MD

Published in: Annals of Surgical Oncology | Issue 3/2016

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Abstract

Background

Endometrial cancer arising in adenomyosis (EC-AIA) is a rare entity of endometrial cancer, and its clinical significance has not been well studied. This study aimed to examine the tumor characteristics and survival outcomes of EC-AIA.

Methods

An exploratory analysis was performed to compare EC-AIA and historical control cases. For this study, EC-AIA cases were identified via a systematic literature search using PubMed/MEDLINE with entry keywords “endometrial cancer OR uterine cancer” AND “adenomyosis” (n = 46). The control group comprised consecutive non-EC-AIA cases from four institutions that had hysterectomy-based surgical staging (n = 1294). Patient demographics, pathology results, and survival outcomes were evaluated between the two groups.

Results

The EC-AIA group was significantly older than the control group (58.9 vs. 55.3 years; P = 0.032). In terms of tumor characteristics, 56.5 % of the EC-AIA cases showed tumor within the myometrium without endometrial extension, and the EC-AIA group was significantly more likely to have tumors with more than 50 % myometrial invasion (51.6 vs. 26.6 %; P = 0.002) and serous/clear cell histology (22.2 vs. 8.2 %, P = 0.002) while less likely to express estrogen receptor (14.3 vs. 84.6 %; P < 0.001). Grade and stage distributions were similar (P > 0.05). In the univariate analysis, the EC-AIA group had a significantly poorer disease-free survival than the control group (5-year rate: 71.4 vs. 80.6 %; P = 0.014). In the multivariate analysis, with control for age, ethnicity, histology, grade, and stage, EA-CIC remained an independent prognostic factor for decreased disease-free survival (adjusted hazard ratio, 3.07; 95 % confidence interval 1.55–6.08; P = 0.001).

Conclusions

The study suggested that endometrial cancer arising in adenomyosis may be an aggressive variant of endometrial cancer.
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Metadata
Title
Tumor Characteristics and Survival Outcome of Endometrial Cancer Arising in Adenomyosis: An Exploratory Analysis
Authors
Koji Matsuo, MD, PhD
Aida Moeini, MD
Hiroko Machida, MD
Christopher A. Scannell, PhD
Jennifer K. Casabar, BS
Mamoru Kakuda, MD
Sosuke Adachi, MD, PhD
Jocelyn Garcia-Sayre, MD
Yutaka Ueda, MD, PhD
Lynda D. Roman, MD
Publication date
01-03-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 3/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4952-y

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