Uterine adenosarcomas: A dual-institution update on staging, prognosis and survival

Bernard, Brandon; Clarke, Blaise A.; Malowany, Janet I.; McAlpine, Jessica; Lee, Cheng‐Han; Atenafu, Eshetu G.; Ferguson, Sarah E.; Mackay, Helen

doi:10.1016/j.ygyno.2013.09.011

Cited by 32 publications

(40 citation statements)

References 18 publications

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“…6,8,10,18,27 In this study, 1.2% had lymph node metastasis. No difference was seen in terms of OS or DFS for patients who did or did not undergo lymphadenectomy.…”

Section: Discussionmentioning

confidence: 50%

“…2,8 The 5-year OS of patients with SO is 50% to 60%, whereas it is 70% to 80% in those without SO. 7,18 Patients with no MI have an 83.3% to 84% 5-year OS; patients with one-half MI or less have a 63% to 69% 5-year OS, and patients with more than one-half MI have a 63% 5-year OS. 10,18 Furthermore, LVI was reported to be associated with a shorter progression-free survival, DFS, and OS, as well as an increased risk of recurrence, 60% versus 24%.…”

Section: Discussionmentioning

confidence: 99%

“…16 Seventy to eighty percent of uterine adenosarcoma patients will present with stage I disease. 8,17,18 Given the rarity of adenosarcoma, there are limited data to guide treatment decisions in the primary setting. Current treatment recommendations are derived solely from small retrospective series or extrapolation of the treatment of the other uterine cancers, such as uterine leiomyosarcoma and uterine carcinosarcoma.…”

mentioning

confidence: 99%

“…8 The 5-year OS of patients with SO is 50% to 60%, and 5-year OS of patients without SO is 70% to 80%. 7,18 Other, previously reported possible prognostic factors include MI, 10,18 lymphovascular invasion (LVI), 6,8 size, and rhabdomyosarcoma elements. 2 Race and older age have been suggested as clinical prognostic factors.…”

mentioning

confidence: 99%

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The Importance of Lymphovascular Invasion in Uterine Adenosarcomas: Analysis of Clinical, Prognostic, and Treatment Outcomes

Nathenson

Conley

Lin

et al. 2018

Int J Gynecol Cancer

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This study highlights the importance of LVI as a prognostic factor and confirms the prognostic significance of SO, MI, age, resection status, and FIGO stage for adenosarcoma. Furthermore, this study suggests that there is no additional benefit to adjuvant radiation. The standard-of-care treatment for adenosarcoma should remain total abdominal hysterectomy bilateral salpingo-oophorectomy +/- lymphadenectomy and no adjuvant radiation.

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“…6,8,10,18,27 In this study, 1.2% had lymph node metastasis. No difference was seen in terms of OS or DFS for patients who did or did not undergo lymphadenectomy.…”

Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Importance of Lymphovascular Invasion in Uterine Adenosarcomas: Analysis of Clinical, Prognostic, and Treatment Outcomes

Nathenson

Conley

Lin

et al. 2018

Int J Gynecol Cancer

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“…When distant metastasis is present, more than 80% of patients die of their disease [15,27]. Although surgery is the mainstay of treatment, adjuvant therapy in the form of chemotherapy, radiation, or both may prolong survival [28] if adverse prognostic features are present.…”

Section: Discussionmentioning

confidence: 99%

Targeted genomic analysis of Müllerian adenosarcoma

Howitt

Sholl

Cin

et al. 2014

The Journal of Pathology

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Müllerian adenosarcoma (MA) is a rare mixed mesenchymal tumour of the female genital tract, composed of malignant stroma and benign-appearing epithelium. Sarcomatous overgrowth (SO) is the only established histological variable associated with higher stage and shorter survival. Specific molecular or immunohistochemistry (IHC) tools for the diagnosis of MA are lacking. Our goal was to study genomic mutations and copy number variations (CNVs) in MA to understand better its pathobiology, and develop specific diagnostic and prognostic tools. DNA was extracted from 20 samples of MA from 18 subjects (12 without SO and 6 with SO), including two in which areas of both typical MA histology and SO were independently tested. Samples were analysed using a targeted next-generation sequencing assay interrogating exonic sequences of 275 cancer genes for mutations and CNVs as well as 91 introns across 30 genes for cancer-associated rearrangements. The mean number of mutations in MA with SO (mean 9.7; range 3-14) did not differ significantly from that in MA without SO (mean 9.6; range 5-16). MA with SO had significantly higher mean numbers of gene-level CNVs (24.6) compared to MA without SO (5; p = 0.0002). The most frequent amplification involved MDM2 and CDK4 (5/18; 28%), accompanied by focal CDK4 and MDM2 and diffuse HMGA2 expression using immunohistochemistry. MYBL1 amplification was seen in 4/18 (22%), predominantly in SO. Alterations in PIK3CA/AKT/PTEN pathway members were seen in 13/18 (72%). Notably, TP53 mutations were uncommon, present in only two cases with SO. Three out of 18 (17%) had mutations in ATRX, all associated with SO. No chromosomal rearrangements were identified. We have identified a number of recurrent genomic alterations in MA, including some associated with SO. Although further investigation of these findings is needed, confirmation of one or more may lead to new mechanistic insights and novel markers for this often difficult-to-diagnose tumour.

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Prognostic Factors in Uterine Cancer

Baker¹,

Oliva

2015

Current Clinical Oncology

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Uterine adenosarcomas: A dual-institution update on staging, prognosis and survival

Cited by 32 publications

References 18 publications

The Importance of Lymphovascular Invasion in Uterine Adenosarcomas: Analysis of Clinical, Prognostic, and Treatment Outcomes

The Importance of Lymphovascular Invasion in Uterine Adenosarcomas: Analysis of Clinical, Prognostic, and Treatment Outcomes

Targeted genomic analysis of Müllerian adenosarcoma

Prognostic Factors in Uterine Cancer

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