Endometriosis/adenomyosis status is not an independent predictor of endometrial cancer survival

Although endometrial cancer patients who had histologically confirmed endometriosis/adenomyosis achieved better overall survival than those without, the benefit was related to stage, grade, age and subtype. histological.

Endometriosis/adenomyosis status does not appear to be an independent prognostic factor for survival in endometrial cancer, although these patients appear to have higher overall survival (OS) than those without (P <.005 according to a study published in the>International Journal of Cancer.

People with endometrial cancer and endometriosis/adenomyosis tended to be younger at diagnosis with early stage disease, endometrioid histology, and low-grade tumors. The 5-year OS rates for the endometriosis/adenomyosis cohort were 84.8% (95% CI, 84.6% to 88.1%) versus 71.6% (95% CI, 71, 1% to 72.0%) for the cohort without endometriosis/adenomyosis (HR, 0.63; 95% CI, 0.59-0.69). Significant confounders included age, stage, disease subtype, histological grade, surgery, and chemotherapy rate (HR, 0.98; 95% CI, 0.90-1, 06).

“We found an increase in survival in women with endometrial cancer and histologically proven endometriosis or adenomyosis. The increase in prognosis appears to be significant due to a younger age at time of diagnosis of endometrial cancer, earlier stage of disease, more favorable histological subtype, and lower grade tumors with higher surgery rate and lower chemotherapy rate in the group of women with endometrial cancer and endometriosis/adenomyosis Future studies should investigate the exact mechanism of these more favorable tumor characteristics,” the researchers report.

The retrospective analysis included patients with epithelial endometrial cancer who had been diagnosed between 1990 and 2015. The control group consisted of patients with endometrial cancer who had no histologically confirmed endometriosis/adenomyosis. Investigators excluded people who were diagnosed with endometriosis/adenomyosis more than six months after their cancer diagnosis.

A total of 41,001 patients were eligible for analysis, of whom 1,755 had endometrial cancer and endometriosis/adenomyosis. Investigators reported that 161 patients were excluded from the population, including 114 patients without epithelial histology and 47 who were diagnosed with endometriosis or adenomyosis six months after their cancer diagnosis. The final population comprised 40,840 patients, 4.2% of whom had histologically proven endometriosis or adenomyosis.

A total of 1236 and 320 patients had adenomyosis and endometriosis, respectively. Of these patients, 145 had both endometriosis and adenomyosis. The median age at diagnosis of endometriosis and adenomyosis was 57 years and 61 years, respectively.

The majority of endometriosis/adenomyosis diagnoses (93.7%) were concurrent with endometrial cancer diagnoses. In the cohorts with and without endometriosis/adenomyosis, 40% and 44% of patients, respectively, had unspecified adenocarcinoma. Low-grade cancers were present in 63% of patients with endometriosis, 57% with adenomyosis, 70% with endometriosis and adenomyosis, and 52% of the control cohort. Additionally, surgery was more common in the endometriosis/adenomyosis cohort, although they received chemotherapy less often.

The median follow-up from diagnosis of endometrial cancer until death, emigration or end of the study was 11 years for the endometriosis/adenomyosis group and 8 years for the control group. Survival differences between the endometriosis and adenomyosis cohorts were not statistically significant. Median OS was 20 years in the endometriosis/adenomyosis cohort versus 13 years in the control cohort (P <.0005 additionally the os rates were ci to and in endometriosis adenomyosis cohorts respectively.>

A total of 35,542 patients were eligible for analysis, 5,298 having been excluded for missing values. Investigators reported several hazard ratios for the comparison of OS versus patients without endometriosis or adenomyosis, including 0.68 (95% CI, 0.57-0.82) in the endometriosis cohort, 0, 65 (95% CI, 0.59-0.71) in the adenomyosis cohort and 0.45 (95% CI, 0.33-0.61) in the endometriosis/adenomyosis cohort.

Reference

Hermens M, van Altena AM, van der Aa M, et al. Endometrial cancer prognosis in women with endometriosis and adenomyosis: a retrospective national cohort study of 40,840 women. Int J Can. 2022;150(9):1439-1446. doi:10.1002/ijc.33907

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