Uterine adenosarcoma in Japan: Clinicopathologic features, diagnosis and management

• Published in: Asia-Pacific journal of clinical oncology Vol. 14; no. 4; pp. 318 - 325
• Main Authors: Tate, Keisei, Watanabe, Reiko, Yoshida, Hiroshi, Shimizu, Hanako, Uehara, Takashi, Ishikawa, Mitsuya, Ikeda, Shun‐ichi, Hiraoka, Nobuyoshi, Kato, Tomoyasu
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.08.2018
• Subjects: Adenosarcoma - diagnosis; Adenosarcoma - pathology; Adenosarcoma - therapy; Adolescent; Adult; Aged; Aged, 80 and over; Autopsy; Child; Cohort Studies; Data processing; Diagnosis; Female; Humans; Japan; Japanese cases; literature review; Literature reviews; Malignancy; Metastases; Metastasis; Middle Aged; Mortality; Neoplasm Recurrence, Local - pathology; Patients; Prognosis; Retrospective Studies; Therapeutic applications; uterine adenosarcoma; Uterine Neoplasms - diagnosis; Uterine Neoplasms - pathology; Uterine Neoplasms - therapy; Uterus; Young Adult; Japan; Japanese cases; literature review; uterine adenosarcoma
• ISSN: 1743-7555; 1743-7563
• DOI: 10.1111/ajco.12859

Aim Uterine adenosarcoma is a rare malignancy with limited cohort data in Asian countries. This study evaluated the clinicopathologic features of Japanese patients with uterine adenosarcoma and their potential treatment challenges. Methods A retrospective chart review was performed at the National Cancer Center Hospital, Japan from 2000 to 2016. A literature search for Japanese cases of uterine adenosarcoma was conducted using PubMed, Japanese Central Review of Medicine, and the Annual of Pathological Autopsy Cases in Japan. Only histologically confirmed cases of uterine adenosarcoma were included. All collected data were analyzed. Results A total of 110 cases was identified (6 from our hospital and 104 from the literature review). Most baseline characteristics were similar to those reported in western countries. Death due to the disease was observed in 34% (29/86) of patients, whereas patients with stage IA disease showed a 13% (4/30) recurrence rate and a 3.3% (1/30) mortality rate. Preoperative radiological and pathological examinations occasionally failed to help reach the correct diagnosis. In cases of sarcomatous overgrowth, the recurrence and mortality rates were 45% (9/20) and 35% (7/20), respectively. Distant recurrence occurred in 44% (12/27) of cases, 75% of which included lung metastasis. Conclusions This study showed the clinicopathologic features of Japanese patients with uterine adenosarcoma and suggested potential solutions for improving prognosis including early treatment based on a timely diagnosis, the development of effective adjuvant therapy for patients at high risk of recurrence, and optimal follow‐up focusing on late recurrence and lung metastasis.