Molecular classification and clinical significance of endometrial cancer complicated with adenomyosis

This retrospective study analyzed 131 surgically treated endometrial cancer cases from a single hospital (21 with coexisting adenomyosis, 110 without) using high-throughput next-generation sequencing to classify tumors into WHO molecular subtypes (POLE-mutated, MMRd, p53-mutated, NSMP) and to compare clinicopathological features, including serum CA125 and surgical FIGO stage. The molecular subtype distribution did not differ significantly between endometrial cancer with adenomyosis and endometriosis adenocarcinoma without simultaneous adenomyosis, but serum CA125 levels were higher and surgical pathological staging differed, with more stage IIIA cases reported in the adenomyosis group and more stage II cases in the non-adenomyosis group. The paper reports no significant differences between groups in many other characteristics, such as age, BMI, menopausal status, depth of myometrial invasion, LVSI, tumor size, and histologic grade, and it evaluated progression-free survival using Kaplan–Meier methods. This paper is centrally about endometriosis and adenomyosis—specifically adenomyosis, examining how coexisting adenomyosis alters molecular subtype distribution and clinicopathological features in endometrial cancer, with comparisons to an endometriosis-associated adenocarcinoma group.

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