Impact of adenomyosis on the prognosis of patients with endometrial cancer

Raimondo, Diego; Raffone, Antonio; Travaglino, Antonio; Maletta, Manuela; Casadio, Paolo; Ambrosio, Marco; Aru, Anna Chiara; Santoro, Angela; Zannoni, Gian Franco; Insabato, Luigi; Mollo, Antonio; Zullo, Fulvio; Seracchioli, Renato

doi:10.1002/ijgo.13818

Cited by 12 publications

(16 citation statements)

References 37 publications

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“…Type I endometrial cancers are commonly associated with a relatively good prognosis [8]. A recent meta-analysis showed that women with adenomyosis and endometrial cancer had longer overall survival when compared to women with endometrial cancer without adenomyosis [21]. However, in this study it was not possible to calculate multivariate hazard ratios.…”

Section: Endometrial Cancer Subtypesmentioning

confidence: 79%

Endometrial Cancer Incidence in Endometriosis and Adenomyosis

Hermens

Altena

Velthuis

et al. 2021

Cancers

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Women with histologically proven endometriosis/adenomyosis have an increased risk of ovarian cancer. Small studies show conflicting results on the endometrial cancer risk in women with endometriosis/adenomyosis. Therefore, we assessed the incidence of endometrial cancer in women with histologically proven endometriosis or adenomyosis. We performed a population-based retrospective cohort study of 129,862 women with histologically proven endometriosis/adenomyosis, matched with 132,700 women with a nevus selected from the Dutch pathology registry between 1990 and 2015. Histology results for endometrial cancer were retrieved. Crude and age-adjusted odds ratios for endometrial cancer were estimated. In the endometriosis/adenomyosis group, 1827 (1.4%) women had a histological report on endometrial cancer, and in the nevus group, 771 (0.6%) women. The age-adjusted OR for endometrial cancer was 2.58 (95%CI 2.37–2.81). After excluding the first year of follow-up, the age-adjusted OR was 0.76 (95%CI 0.63–0.92), indicating that endometrial cancer is most often found at time of histological diagnosis of endometriosis/adenomyosis. In around 20% of the endometrial cancer cases, the endometrial cancer was not recognized until after hysterectomy. Of these women, 35% had no prior (micro)curettage or biopsy. This study shows an increased incidence of endometrial cancer in women with histologically proven endometriosis and adenomyosis.

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Section: Endometrial Cancer Subtypesmentioning

confidence: 79%

Endometrial Cancer Incidence in Endometriosis and Adenomyosis

Hermens

Altena

Velthuis

et al. 2021

Cancers

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“…Although the association between adenomyosis and EC prevalence has not been proven [9], several authors have hypothesized a better EC prognosis in patients with underlying uterine adenomyosis [10][11][12]. However, the underlying factors are still unknown.…”

Section: Main Findings and Interpretationmentioning

confidence: 99%

“…The presence of co-existent adenomyosis has been reported to halve the risk of death in EC patients [10][11][12]. Unfortunately, it is still unclear if this better prognosis is related to a more favorable clinical profile (e.g., younger age or lower BMI) or a different underlying pathogenesis of EC in this subset of patients.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Patients with Endometrial Cancer and Adenomyosis

Casadio

Raffone

Maletta

et al. 2021

Cancers

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A better endometrial cancer (EC) prognosis in patients with coexistent adenomyosis has been reported. Unfortunately, it is still unclear if this better prognosis is related to a more favorable clinical profile of adenomyosis patients. We aimed to evaluate differences in the clinical profiles of EC patients with and without adenomyosis. A systematic review and meta-analysis was performed by searching seven electronics databases for all studies that allowed extraction of data about clinical characteristics in EC patients with and without adenomyosis. Clinical characteristics assessed were: age, Body Mass Index (BMI), premenopausal status, and nulliparity. Mean difference in mean ± standard deviation (SD) or odds ratio (OR) for clinical characteristics between EC patients with and without adenomyosis were calculated for each included study and as a pooled estimate, and graphically reported on forest plots with a 95% confidence interval (CI). The Z test was used for assessing the overall effect by considering a p value < 0.05 as significant. Overall, eight studies with 5681 patients were included in the qualitative analysis, and seven studies with 4366 patients in the quantitative analysis. Pooled mean difference in mean ± SD between EC women with and without adenomyosis was −1.19 (95% CI: −3.18 to 0.80; p = 0.24) for age, and 0.23 (95% CI: −0.62 to 1.07; p = 0.60) for BMI. When compared to EC women without adenomyosis, EC women with adenomyosis showed a pooled OR of 1.53 (95% CI: 0.92 to 2.54; p = 0.10) for premenopausal status, and of 0.60 (95% CI: 0.41 to 0.87; p = 0.007) for nulliparity. In conclusion, there are not significant differences in clinical characteristics between EC patients with and without adenomyosis, with the exception for nulliparity. Clinical features seem to not underlie the better EC prognosis of patients with adenomyosis compared to patients without adenomyosis.

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“…However, in a multivariate analysis, the risk of EC recurrence in patients with adenomyosis seemed to be irrelevant. Finally, in the case of overall survival, a multivariate analysis was not performed [ 56 ].…”

Section: Clinical Studiesmentioning

confidence: 99%

Adenomyosis as a Risk Factor for Myometrial or Endometrial Neoplasms—Review

Szubert

Koziróg

Wilczyński

2022

IJERPH

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Adenomyosis is a common benign gynecological condition, defined as an extension of endometrial tissue into the myometrium. Some studies suggest that adenomyosis could be a favorable prediction factor associated with survival outcomes in endometrial cancer. The aim of our systematic review was to investigate the current knowledge regarding adenomyosis and a possible molecular mechanism of carcinogenesis in adenomyotic lesions. In addition, the long-term prognosis for patients with endometrial cancer and coexisting adenomyosis (and endometriosis) was a key point of the research. The current literature was reviewed by searching PubMed, using the following phrases: “adenomyosis and endometrial cancer” and “malignant transformation of adenomyosis”. According to the literature, genetic mutations, epigenetic changes, and inactivation of specific tumor suppressor genes in adenomyosis are still poorly understood. Data regarding the influence of adenomyosis on survival outcomes in endometrial cancer seem to be contradictory and require further clinical and molecular investigation.

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Impact of adenomyosis on the prognosis of patients with endometrial cancer

Abstract: Ϯ Diego Raimondo and Antonio Raffone equally contributed to the study.

Cited by 12 publications

References 37 publications

Endometrial Cancer Incidence in Endometriosis and Adenomyosis

Endometrial Cancer Incidence in Endometriosis and Adenomyosis

Clinical Characteristics of Patients with Endometrial Cancer and Adenomyosis

Adenomyosis as a Risk Factor for Myometrial or Endometrial Neoplasms—Review

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