Exploring the influence of adenomyosis on endometrial cancer

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas Pub Date : 2026-04-01 Epub Date: 2026-02-06 DOI:10.1016/j.maturitas.2026.108872

Ran Matot , Danna Englander , Yarden Sela , Nati Bor , Yossi Geron , Gil Zeevi , Effi Yeoshoua , Oded Raban , Ram Eitan

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引用次数: 0

Abstract

Objectives

To evaluate whether coexisting adenomyosis is associated with distinct clinicopathological features in women with endometrial cancer.

Study design

This retrospective cohort included 399 women who had undergone hysterectomy for histologically confirmed endometrial carcinoma at a tertiary center between 2016 and 2024. Patients were stratified according to the presence or absence of adenomyosis on final pathology. Clinical and pathological characteristics were compared, and multivariable logistic regression was used to adjust for potential confounders.

Main outcome measures

Associations between adenomyosis and tumor invasiveness, stage at diagnosis, and other pathological features.

Results

The cohort consisted predominantly of postmenopausal women, with a median age of 67 years. Adenomyosis was identified in 94 patients (23.6%). Women with adenomyosis were more likely to have non-invasive tumors (1.1% vs. 6.8%; p = 0.037) and early-stage disease (Stage I–II: 91.3% vs. 80.8%; p = 0.029). After adjustment for age, adenomyosis was associated with lower odds of advanced-stage disease (adjusted odds ratio 0.40; 95% confidence interval 0.17–0.91). In a comprehensive model including age, histologic subtype, and peritoneal cytology, this association remained significant (adjusted odds ratio 0.20; 95% confidence interval 0.05–0.78). Endometrioid histology was independently protective (adjusted odds ratio 0.32; 95% confidence interval 0.13–0.75), while positive cytology was linked to advanced-stage disease (adjusted odds ratio 4.40; 95% confidence interval 1.86–10.40).

Conclusions

Coexisting adenomyosis is associated with less invasive tumors and a lower likelihood of advanced-stage endometrial cancer. These findings suggest adenomyosis may influence tumor progression, potentially through structural or biological mechanisms. Prospective studies are needed to clarify the underlying biology and long-term prognostic impact.

Trial registration: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Rabin Medical Center (Date 3 July 2025 /No RMC- 0037-25).

查看原文本刊更多论文

探讨子宫腺肌症对子宫内膜癌的影响。

目的：评价子宫内膜癌患者并发子宫腺肌症是否与不同的临床病理特征相关。研究设计：该回顾性队列包括399名2016年至2024年间在三级中心因组织学证实的子宫内膜癌接受子宫切除术的妇女。根据最终病理是否存在子宫腺肌症对患者进行分层。比较临床和病理特征，并使用多变量逻辑回归来调整潜在的混杂因素。主要结局指标：子宫腺肌症与肿瘤侵袭性、诊断分期和其他病理特征之间的关系。结果：该队列主要由绝经后妇女组成，中位年龄为67岁。94例（23.6%）患者检出子宫腺肌症。患有子宫腺肌症的女性更容易患非侵袭性肿瘤（1.1% vs. 6.8%, p = 0.037）和早期疾病（I-II期：91.3% vs. 80.8%, p = 0.029）。在年龄校正后，子宫腺肌症与较低的晚期疾病发生率相关（校正优势比0.40；95%可信区间0.17-0.91）。在包括年龄、组织学亚型和腹膜细胞学在内的综合模型中，这种关联仍然显著（校正优势比0.20；95%可信区间0.05-0.78）。子宫内膜样组织独立具有保护作用（校正优势比0.32,95%可信区间0.13-0.75），而细胞学阳性与晚期疾病相关（校正优势比4.40,95%可信区间1.86-10.40）。结论：共存的子宫腺肌症与侵袭性较小的肿瘤和较低的晚期子宫内膜癌的可能性相关。这些发现表明子宫腺肌症可能通过结构或生物学机制影响肿瘤进展。需要前瞻性研究来阐明潜在的生物学和长期预后影响。试验注册：本研究按照赫尔辛基宣言的原则进行。Rabin医疗中心伦理委员会已批准（日期2025年7月3日/编号RMC- 0037-25）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Maturitas 医学-妇产科学

CiteScore

9.10

自引率

2.00%

发文量

142

审稿时长

40 days

期刊介绍： Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life