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Long-term outcome and natural history of uterine adenosarcomas

  • Author Footnotes
    1 These two authors contributed equally to the work.
    Rebecca Arend
    Footnotes
    1 These two authors contributed equally to the work.
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Súrgenos, USA
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  • Author Footnotes
    1 These two authors contributed equally to the work.
    Madhu Bagaria
    Footnotes
    1 These two authors contributed equally to the work.
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Súrgenos, USA
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  • Sharyn N. Lewin
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Súrgenos, USA

    Herbert Irving Comprehensive Cancer Center, USA
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  • Xuming Sun
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Súrgenos, USA
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  • Israel Deutsch
    Affiliations
    Department of Radiation Oncology, Columbia University College of Physicians and Surgeons, USA

    Herbert Irving Comprehensive Cancer Center, USA
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  • William M. Burke
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Súrgenos, USA
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  • Thomas J. Herzog
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Súrgenos, USA

    Herbert Irving Comprehensive Cancer Center, USA
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  • Jason D. Wright
    Correspondence
    Corresponding author. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Ave, 8th Floor, New York, NY 10032, USA. Fax: +1 212 305 3412.
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Súrgenos, USA

    Herbert Irving Comprehensive Cancer Center, USA
    Search for articles by this author
  • Author Footnotes
    1 These two authors contributed equally to the work.

      Abstract

      Objective

      Adenosarcomas are rare tumors composed of a benign epithelium in combination with a malignant mesenchymal component. We examined the natural history of uterine adenosarcomas and compared the outcome of uterine adenosarcoma and carcinosarcoma.

      Methods

      Patients with uterine adenosarcomas and carcinosarcomas registered in the Surveillance, Epidemiology, and End Results database between 1988 and 2006 were examined. Survival was analyzed using Cox proportional hazards model and the Kaplan–Meier method.

      Results

      A total of 5496 patients including 544 (10%) with adenosarcomas were identified. Patients with adenosarcomas tended to be younger and were more likely to have early-stage tumors (p<0.0001) In a multivariate model patients with adenosarcomas were 65% (HR=0.35; 95% CI, 0.28–0.45) less likely to die from their tumors than women with carcinosarcomas. Five-year survival was 79% (95% CI, 75–84%) for stage I adenosarcomas and 51% (95% CI, 49–54%) for carcinosarcomas. For stage III disease, 5-year survival for adenosarcomas was 48% (95% CI, 29–65%) vs. 24% (95% CI, 20–27%) for carcinosarcomas.

      Conclusion

      The majority of women with uterine adenosarcoma present with early-stage tumors and have a favorable outcome. Despite the overall favorable prognosis for most patients, survival is only 63–69% for women whose tumors invade into the wall of the uterus and lower than 50% for disease spread beyond the uterus.

      Keywords

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