Clinicopathologic analysis of mullerian adenosarcoma: the M.D. Anderson Cancer Center experience

Verschraegen CF, C F Verschraegen, Vasuratna A, A Vasuratna, C Edwards, Edwards C, Freedman R, R Freedman, A P Kudelka, Kudelka AP, Tornos C, C Tornos, Kavanagh JJ, J. J. Kavanagh
Oncology reports · 1998 · doi:10.3892/or.5.4.939 · PMID:9625851
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This clinicopathologic analysis of 41 adenosarcoma patients found that the uterus is the most common origin, surgery is the primary treatment, and sarcomatous overgrowth predicts a poor prognosis, although overall survival is 48 months.

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This clinicopathologic study reviewed 41 patients diagnosed with mullerian adenosarcoma of the female genital tract from 1982 to 1996 at the M.D. Anderson Cancer Center, documenting presenting symptoms, tumor origin sites, treatment approaches, response, recurrence, and prognostic histologic factors. Most patients presented with vaginal bleeding (71%), and in 71% the tumor originated from the uterus; surgery was the mainstay, with platinum-based chemotherapy showing efficacy in inoperable cases. The overall response rate after primary therapy was 92.5%, median survival was 48 months, recurrence occurred in 38%, and sarcomatous overgrowth predicted poorer prognosis, while myometrial invasion and stage were less prognostic; the authors also note no relationship to endometriosis observed in this cohort. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

The records of 41 patients diagnosed with adenosarcoma of the female genital tract between 1982 and 1996 were reviewed. The median age at diagnosis is 51 years (range, 14-84). The most common symptom is vaginal bleeding (71%). Clinical signs at presentation include pelvic mass (37%), uterine polyps (29%), and enlarged uterus (22%). In 71% of patients, the tumor originates from the uterus. Other sites include ovary (15%), pelvis (12%), cervix (2%). A history of thyroid cancer, benign ovarian cyst, and polycystic ovarian disease is found more frequently than expected in this patient population, whereas no relationship to endometriosis is observed. Surgery is the mainstay of treatment, but platin-based chemotherapy given upfront in inoperable patient has definite efficacy. An overall response rate of 92.5% was observed after primary therapy (surgery with or without radiotherapy, and/or chemotherapy), with a median survival of 48 months (range, 1-174). Thirty-eight percent of patients had recurrent disease. The median time to recurrence is 12 months (range, 5-132). Although 60% of patients with recurrence achieved a complete remission after treatment, only 1 (8%) is alive without disease, and 3 (22%), with disease at the time of this analysis. In our series, histologic sarcomatous overgrowth is a predictor of poor prognosis (p<0.03), however myometrial invasion and stage of disease seem to be of less prognostic significance. Adenosarcoma is a tumor with a fair prognosis. Most tumor can be cured with surgery, but recurrence carries a bad prognosis.
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Print ISSN: 1021-335X Online ISSN: 1791-2431 International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease. International Journal of Oncology is an international journal devoted to oncology research and cancer treatment. Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery. Oncology Reports is an international journal devoted to fundamental and applied research in Oncology. Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine. Oncology Letters is an international journal devoted to Experimental and Clinical Oncology. Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology. International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis. Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology. Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition. Publishes open-access research on using epigenetics to advance understanding and treatment of human disease. An International Open Access Journal Devoted to General Medicine. Article - Authors: - Pages: 939-983|Published online on: July 1, 1998https://doi.org/10.3892/or.5.4.939 - Expand metrics + The records of 41 patients diagnosed with adenosarcoma of the female genital tract between 1982 and 1996 were reviewed. The median age at diagnosis is 51 years (range, 14-84). The most common symptom is vaginal bleeding (71%). Clinical signs at presentation include pelvic mass (37%), uterine polyps (29%), and enlarged uterus (22%). In 71% of patients, the tumor originates from the uterus. Other sites include ovary (15%), pelvis (12%), cervix (2%). A history of thyroid cancer, benign ovarian cyst, and polycystic ovarian disease is found more frequently than expected in this patient population, whereas no relationship to endometriosis is observed. Surgery is the mainstay of treatment, but platin-based chemotherapy given upfront in inoperable patient has definite efficacy. An overall response rate of 92.5% was observed after primary therapy (surgery with or without radiotherapy, and/or chemotherapy), with a median survival of 48 months (range, 1-174). Thirty-eight percent of patients had recurrent disease. The median time to recurrence is 12 months (range, 5-132). Although 60% of patients with recurrence achieved a complete remission after treatment, only 1 (8%) is alive without disease, and 3 (22%), with disease at the time of this analysis. In our series, histologic sarcomatous overgrowth is a predictor of poor prognosis (p<0.03), however myometrial invasion and stage of disease seem to be of less prognostic significance. Adenosarcoma is a tumor with a fair prognosis. Most tumor can be cured with surgery, but recurrence carries a bad prognosis. Copy and paste a formatted citation Spandidos Publications style Verschraegen C, Vasuratna A, Edwards C, Freedman R, Kudelka A, Tornos C and Kavanagh J: Clinicopathologic analysis of mullerian adenosarcoma: the M.D. Anderson Cancer Center experience.. Oncol Rep 5: 939-983, 1998. APA Verschraegen, C., Vasuratna, A., Edwards, C., Freedman, R., Kudelka, A., Tornos, C., & Kavanagh, J. (1998). Clinicopathologic analysis of mullerian adenosarcoma: the M.D. Anderson Cancer Center experience.. Oncology Reports, 5, 939-983. https://doi.org/10.3892/or.5.4.939 MLA Verschraegen, C., Vasuratna, A., Edwards, C., Freedman, R., Kudelka, A., Tornos, C., Kavanagh, J."Clinicopathologic analysis of mullerian adenosarcoma: the M.D. Anderson Cancer Center experience.". Oncology Reports 5.4 (1998): 939-983. Chicago Verschraegen, C., Vasuratna, A., Edwards, C., Freedman, R., Kudelka, A., Tornos, C., Kavanagh, J."Clinicopathologic analysis of mullerian adenosarcoma: the M.D. Anderson Cancer Center experience.". Oncology Reports 5, no. 4 (1998): 939-983. https://doi.org/10.3892/or.5.4.939

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Condition tags

endometriosis

MeSH descriptors

Adenosarcoma Cancer Care Facilities Genital Neoplasms, Female Adenosarcoma Adenosarcoma Adolescent Adult Aged Aged, 80 and over Female Genital Neoplasms, Female Genital Neoplasms, Female Humans Middle Aged Prognosis Retrospective Studies Texas Treatment Outcome

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