Prognostic Indicators of Uterine Adenosarcoma Based on 2010 AJCC Staging Criteria – A Clinicopathologic Study of 39 Cases over 20 Years.
Pi-Yu Chen, Joyce J Ou, C James J Sung, M Ruhul R Quddus, W Dwayne D Lawrence, Margaret M Steinhoff. Warrent Alpert Medical School of Brown University & Women & Infants Hospital, Providence, RI; Changhua Christian Hospital, Taiwan
Background: Uterine adenosarcomas are rare tumors composed of benign epithelium in combination with a malignant mesenchymal component. Due to the rarity of this tumor, American Joint Committee on Cancer (AJCC) staging criteria did not provide specific provisions for staging this lesion until the new 7th edition in 2010. The aim of this study is to determine the prognostic indicators in uterine adenosarcoma based on the new 2010 AJCC staging criteria.
Design: Patients with uterine adenosarcomas from our archive between 1991 and 2010 were retrieved. Parameters including age, follow up period, presence of sarcomatous overgrowth, homologous or heterologous elements, and staging information (as per 2010 AJCC criteria: depth of invasion, extrauterine spread, and lymph nodes status) were extracted. The time interval of recurrence was calculated from initial diagnosis to documented first recurrence of disease.
Results: Thirty-nine cases of uterine adenosarcomas with sufficient staging and follow-up information were identified within the specified study period. The mean patient age was 59.2 years (range: 36-97, median: 58). Twenty-one cases were staged as pT1a, 13 as stage pT1b, 1 as stage pT1c, 1 as stage pT2a, 2 as stage pT3a, and 1 as stage pT3b. Sarcomatous overgrowth was present in 19 cases (49%), and heterologous elements identified in 5 cases (14%). The average follow-up interval was 44 months (range: 1-185, median 25). Seven cases (5 in stage pT1a, 1 in stage pT1b and 1 in stage pT1c) recurred in 4-116 months. All 7 cases exhibited sarcomatous overgrowth, and one of them also had concurrent heterologous elements present.
Conclusions: In this limited study, there was no definitive correlation between recurrent disease and stage as defined by the 2010 AJCC staging criteria. We identified a strong association between disease recurrence and the presence of sarcomatous overgrowth in uterine adenosarcomas. A multi-institutional study with a larger cohort may be required to validate the 2010 AJCC staging criteria for uterine adenosarcomas, particularly with respect to long-term overall and disease-free survival outcomes.
Category: Gynecologic & Obstetrics
Wednesday, March 2, 2011 1:00 PM
Poster Session VI # 190, Wednesday Afternoon