Impact of Coexisting Uterine Adenomyosis on the Survival Outcome of Patients with Endometrial Cancer: A Retrospective Cohort Study

Abstract

Objective: To determine the effects of uterine adenomyosis on endometrial cancerrecurrence rates. Methods: This<br />retrospective cohort study reviewed all consecutive patients diagnosed with endometrial cancerwho underwent total<br />hysterectomy-based surgical staging at Srinagarind Hospital between January, 2010 and January, 2016. The patientswere<br />divided into two groups:a uterine adenomyosisgroup and a non-adenomyosis group. Patient demographics, type of<br />surgery, histopathology, stage of endometrial cancer, adjuvant treatment, and survival outcomes were compared.<br />Results: A total 350 patients were enrolled, with 132 (37.71%) in the adenomyosis group and 218 (62.29%) in the nonadenomyosis group. Deep myometrial invasion and lymphovascular space invasion (LVSI) were more commonly found<br />among patients who had no adenomyosis compared to those with adenomyosis(52.8% vs 39.4%, P=0.02 and 53.2%<br />vs. 38.6%, P=0.01). There were no significant differences in terms of five-year recurrence-free survival (HR=1.47;<br />95%CI 0.88-2.44) and five-year overall survival (HR=0.81; 95%CI 0.43-1.53) between the two comparison groups.<br />Conclusion: Coexisting uterine adenomyosis in endometrial cancer wasassociated withdeep myometrial invasion and<br />LVSI but did not have significant impact on survival.