Does adenomyosis influence tumor characteristics and survival in endometrioid-type endometrial cancer??

Background: The coexistence of adenomyosis and cancer of the endometrium has attracted heightened scrutiny, leading to inquiries regarding their possible interactions and clinical ramifications. This study sought to assess the influence of adenomyosis on tumor features and survival outcomes in patients with endometrioid-type endometrial carcinoma.

Materials and methods: A retrospective cohort analysis was performed on 422 patients who underwent surgical intervention for endometrioid-type endometrial carcinoma. The cohort was categorized into two groups according to the presence or absence of adenomyosis. Clinical and pathological data were gathered and evaluated to compare tumor features and survival outcomes between the two cohorts.

Results: Adenomyosis was present in 144 (34.1%) patients. Patients in the adenomyosis group demonstrated significantly higher gravidity and parity compared to those without adenomyosis. Lymphovascular space invasion was detected in 8.3% of the adenomyosis group compared to 17.6% in the non-adenomyosis group (a 53% reduction, p = 0.010). Similarly, rates of myometrial invasion (81.3% vs. 65.5%, p = 0.001), cervical stromal invasion (9.0% vs. 14.1%, p = 0.005), and lymph node metastasis (4.2% vs. 14.4%, p = 0.001) were significantly lower in patients with adenomyosis. The five-year overall survival rate was 90.8% in the adenomyosis group and 87.1% in the non-adenomyosis group, although this difference was not statistically significant (p = 0.689).

Conclusions: This study demonstrates that adenomyosis is associated with a significant reduction in aggressive tumor characteristics such as myometrial invasion, lymphovascular space involvement, and lymph node metastasis in patients with endometrioid-type endometrial cancer. These findings emphasize that adenomyosis may be a potential protective factor in endometrial cancer prognosis and should be considered in clinical risk assessment. Prospective studies with larger cohorts are needed to confirm the long-term effects of adenomyosis on survival.