Coexistence of adenomyosis uteri and endometrial cancer is associated with an improved prognosis compared with endometrial cancer only

Abstract

The present study aimed to identify differences in protein expression in cases of endometrioid endometrial cancer (EEC) with and without coexisting adenomyosis uteri (AM), and to evaluate the histopathological and prognostic distinctions. The total cohort included 22 patients in Group A (patients with concomitant AM and EEC) and 35 patients in Group B (patients affected only by EEC). Evaluation of the following factors was performed: Tumour grade, International Federation of Gynaecology and Obstetrics (FIGO) stage, survival, and expression of estrogen receptor β (ERβ), glycodelin and inhibin βB. Group A (AM and EEC) was associated with a lower tumour grade (G1, 90.9 vs. 45.7%; P=0.001) and a lower FIGO stage (FIGO stage I, 100 vs. 80%; P=0.002) compared with Group B (EEC only). In the survival analysis, Group A was associated with a significantly higher 5-year survival rate (95 vs. 82%; P=0.024) than Group B. In addition, the expression of ERβ in Group A was significantly higher (P<0.001), whereas the expression of glycodelin is significantly lower (P=0.028), compared with Group B. The results of the present study indicate that the presence of AM in cases of EEC may be a positive prognostic factor.

Prognostic significance of co‐existent adenomyosis on outcomes and tumor characteristics of endometrial cancer: A meta‐analysis

“…In previous studies, adenomyosis coexisted with endometrial cancer in 0-70% 14 of cases, which is consistent with the studies we included 6.4-66% of cases. 4,[8][9][10][11][12][15][16][17][18][21][22][23][24] Furthermore, a population-based study comprising 768 patients with adenomyosis alone exhibited a fivefold increased risk of developing endometrial cancer. 25 Despite the common context, the mechanism of action of adenomyosis in endometrial cancer remains elusive.…”

“…These findings were consistent with some previous studies; besides, the results were also in agreement with the current belief that adenomyosis co-existed endometrial cancer exhibit a more favorable prognosis and can present good clinical outcomes for patients with endometrial cancer. [8][9][10][11][12] Some studies agreed that endometrial cancer patients with adenomyosis had a good prognosis due to superficial invasion of the myometrium, low histological grade and the result of early diagnosis.…”

“…Multiple previous studies have suggested that adenomyosis is an independent prognostic factor of endometrial cancer, for limiting the progression of endometrial cancer. [8][9][10][11][12] However, other studies have identified adenomyosis as the precursor of endometrial cancer. [13][14] Conversely, co-existent adenomyosis in endometrial cancer has no impact on survival outcomes according to some studies.…”