Case Report of Successful Childbearing after Conservative Surgery for Cervical Mullerian Adenosarcoma

Kanayama, Seiji; Nakamura, Masamitsu; Oi, Hidekazu; Sugimoto, Sumire; Sasaki, Yasutaka; Uchiyama, Tomoko; Ohbayashi, Chiho; Kobayashi, Hiroshi

doi:10.1155/2017/4187416

Cited by 7 publications

(21 citation statements)

References 17 publications

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“…Some authors claimed that FSS should not be a preferred approach because of its high risk of recurrence [5]. Alternatively, some authors have reported that local tumor excision may been curative in some cases [6][7][8][9][10][11][12][13][14]. In this study, FSS was performed in four patients with cervical adenosarcoma and five with uterine adenosarcoma.…”

Section: Discussionmentioning

confidence: 93%

“…A literature search was performed via PubMed, EMBASE and Web of Science. A total of 16 and 13 cases of cervical and uterine adenosarcoma, respectively, were included [6][7][8][9][10][11][12][13][24][25][26]. One case (case 13) was excluded from the analysis as a result of being lost to follow-up.…”

Section: Oncologic Outcomesmentioning

confidence: 99%

“…Surgery is the mainstay of treatment for adenosarcomas [3]. However, the best surgery procedure and whether fertility-sparing surgery (FSS) can be used in cervical and uterine adenosarcoma remain controversial [5][6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Uterine and Cervical Adenosarcoma: A Retrospective Study of Overall Oncologic Outcomes and Fertility Preservation in Early-Stage Disease

Yuan

Cao

et al. 2019

The Oncologist

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Background The management of adenosarcoma is based on the limited available data. This study aimed to explore the characteristics and oncologic outcomes of patients with uterine and cervical adenosarcoma. Materials and Methods A total of 21 and 32 cases of cervical and uterine adenosarcoma, respectively, were retrospectively reviewed in Peking Union Medical College Hospital between April 2006 and March 2019. Results The median follow‐up time was 37.5 months (range, 1–153 months). The disease progression rate (DPR) was significantly higher in patients with uterine adenosarcoma compared with those with cervical adenosarcoma (28.1% vs. 4.8%). The curve of progression‐free survival significantly differed. For those with cervical adenosarcoma, the presence of a tumor stalk was a protective factor, whereas heterologous elements (HE) presented a risk factor for disease progression. For those with uterine adenosarcoma, the presence of a tumor stalk was an independent protective factor, whereas lymphovascular space invasion (LVSI) was an independent risk factor for disease progression. Moreover, HE was an independent risk factor for mortality. Fertility‐sparing surgery (FSS) was performed in four and five patients with cervical and uterine adenosarcoma, respectively. Regarding FSS, combined with cases in previous studies, the DPR of patients with uterine adenosarcoma was relatively higher compared with those with cervical adenosarcoma. Conclusion We found that cervical adenosarcoma had a better prognosis than uterine adenosarcoma. The presence of a tumor stalk was a protective factor, whereas HE and LVSI were risk factors for prognosis. For those with uterine adenosarcoma, if FSS was administered, robust evaluation would be necessary. The small sample size limits the ability to make any strong conclusions about FSS. Implications for Practice Uterine cervical adenosarcoma had a better prognosis than uterine adenosarcoma. For patients with cervical adenosarcoma, the presence of a tumor stalk was a protective factor and the presence of heterologous elements (HE) was a risk factor for disease progression. For those with uterine adenosarcoma, the presence of a tumor stalk was a protective factor and lymphovascular space invasion was a risk factor for disease progression. Moreover, HE was a risk factor for mortality. Regarding fertility‐sparing surgery (FSS), the disease progression rate was higher in patients with uterine adenosarcoma compared with those with cervical adenosarcoma. For patients with uterine adenosarcoma, if FSS was administered, hysteroscopy and robust imaging evaluation would be necessary.

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Section: Discussionmentioning

confidence: 93%

Section: Oncologic Outcomesmentioning

confidence: 99%

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Uterine and Cervical Adenosarcoma: A Retrospective Study of Overall Oncologic Outcomes and Fertility Preservation in Early-Stage Disease

Yuan

Cao

et al. 2019

The Oncologist

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“…Los sarcomas uterinos son un grupo de neoplasias de origen mesenquimatoso, representando el 8% de las neoplasias malignas del útero 6 . Entre ellos se encuentra el AM, un tumor con potencial maligno bajo que representa el 5-8% de los sarcomas uterinos 7 , descrito originalmente por Clement y Scully en 1974 1,2 . Se origina con mayor frecuencia en el endometrio del cuerpo uterino, pero también puede desarrollarse en el ovario, el cérvix 1,5 , el retroperitoneo y el intestino 8 .…”

Section: Discussionunclassified

“…Se origina con mayor frecuencia en el endometrio del cuerpo uterino, pero también puede desarrollarse en el ovario, el cérvix 1,5 , el retroperitoneo y el intestino 8 . El AM del cérvix representa el 2-9% de todos los AM 7 .…”

Section: Discussionunclassified