Influences of Uterine Adenomyosis On Pathologic Prognostic Characteristics and Survival Time in Patients with Endometrial Cancer

Abstract

Objective: The first aim of the present study was to investigate whether the presence of adenomyosis (AM) had an effect on pathologic prognostic characteristics and survival time in patients with endometrial carcinoma (EC). The second aim was to evaluate the association of AM for each subtype grouping as low-grade endometrioid carcinoma, high-grade endometrioid carcinoma, and high-grade non-endometrioid carcinoma. Methods: The present retrospective observational cohort study was conducted using the institution’s database of patients with EC who underwent staging surgery. The cohort was divided into two groups according to the presence or absence of AM. Additionally, EC subtypes were grouped into low-grade endometrioid, high-grade endometrioid, and high-grade non-endometrioid tumors according to the presence or absence of AM as well. The survival outcomes and pathologic prognostic characteristics were compared between the groups. Results: A total of 518 endometrial cancer patients were analyzed. Overall survival (OS) was similar between patients with and without AM (Cox regression Wald=0.654, p=0.419). In multivariate Cox regression analysis, the presence of AM was not associated with survival time (p=0.378). However, histologic type with grade, lymph vascular space invasion, and metastasis were significant factors predicting the survival time (endometrioid low grade vs endometrioid high grade, p1=0.075 and endometrioid low grade vs non-endometrioid high grade, p2=0.020; p=0.001 and p=0.001, respectively). Survival means for survival time in patients with and without AM in different histologic types with grade was similar for each subgroup (p>0.005 for each group). Conclusion: Our findings indicated that the presence of AM with EC is not an independent prognostic factor for OS.