Does Adenomyosis Impede Spread of Endometrial Cancer

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Does Adenomyosis Impede Spread of Endometrial Cancer Dr. Selçuk Erkılınç Tepecik Education and Research Hospital

Background Adenomyosis is the presence of the endometrial tissue among myometrial tissue. The observation that the patient had adenomyosis had favorable oncologic outcomes made us investigate the effect of adenomyosis in endometrial cancer.

Method This study was conducted at a tertiarry referral centre. The hospital data was reviewed from 2007 to 2016. A total of 1217 diagnosis of endometrial cancer encountered and 80 patients with concurrent adenomyosis constituted study group. Control group was selected according to the grade of tumour. Four times as many as patients were included to the control group for each grade. A total of 320 patients constituted the control group. All pathologic slides in study group were reviewed by pathologists those were experienced in gynecological oncology.

Table I. Demographic and pathologic data of study and control groups Study Control P Age 56±8,9 59±24,8) 0,266 BMI 32,4±7,0 33,4±5,2 0,171 HT 6 (7,5) 110 (35,6) <0,001 DM 5 (6,3) 66 (21,4) 0,001 Surgery 0,779 TAH 9 (11,3) 30 (9,7) TAH+PLND 11 (13,8) 55 (17,8) TAH+PPLND 60 (75) 223 (72,2) Grade 1 44 (55) 163 (52,8) 0,885 Grade 2 30 (37,5) 125 (40,5) Grade 3 21 (6,8) MI < ½ 67 (83,8) 173 (56) ≥ ½ 13 (16,3) 136 (44) LVSI 8 (10) 82 (26,6) 0,002 TD 24,6±15,9 37,4±22,3 Stage I 76 (95) 225 (72,8) II 2 (2,5) 33 (10,7) III-IV 51 (16,5) CT 4 (5) 61 (20,1) RT 17 (21,3) 159 (51,5)

. The Comparison of study and control groups in patients with high grade and low grade tumors High Grade Low Grade Study Control p İnner ½ 28 (77,8) 44 (30,1) <0,001 39 (88,6) 129 (79,1) 0,153 Outer ½ 8 (22,2) 102 (69,9) 5 (11,4) 34 (20,9) LVSI 6 (16,7) 54 (37) 0,02 42 (95,5) 134 (82,7) 0,03 Tumor Diameter 28,6±14,5 44,1±22,9 2 (4,5) 28 (17,3) Stage I 33 (91,7) 86 (58,9) 0,003 43 (97,7) 139 (85,3) 0,047 II 2 (5,6) 24 (16,4) 0 (0) 9 (5,5) III-IV 1 (2,8) 36 (24,7 1 (2,3) 15 (9,2)

Pathologic Findings of the patients with adenomyosis and endometrial cancer N, % Proksimal Adenomyosis 21 (26,5) Distal Adenomyosis 68 (85) Proksimal and Distal 9 (11) Tumor in Adenomyosis 6 (7,6) Distance to Adenomyotic focus <1 mm 32 (40) 1-10 mm 16 (20) >10 mm

Overall Survival

Disease Free Survival

Univariate and Multivariate analysis for endometrial cancer death Univariate Analysis Multivariate Analysis HR 95% CI P Value P value Age 1,04 1,01-1,07 0,006 1,03 0,99-1,07 0,06 MI <1/2 Reference ≥1/2 1,94 1,13-3,32 0,01 G I Tumor G II Tumor 1,72 0,97-3,08 G IIITumor 5,01 2,08-12,03 <0,001 3,6 1,3-10,12 LVSI No Yes 3,02 1,67-5,48 TD <2 cm ≥2 cm 4,20 1,64-10,7 0,003 3,1 1,14-8,53 0,02 RT 1,75 1,01-3,01 0,04 CT 2,58 1,32-5,05 0,005 Adenomyosis 0,15 0,03-0,65 0,35-0,68

Conclussion Our study suggested that patients with endometrial cancer and adenomyosis had favorable pathologic and survival outcomes Presence of adenomyosis may treat like a barrier for spread of endometrial cancer

Thank You