Management of uterine adenosarcomas with and without sarcomatous overgrowth

Edward J. Tanner, Thomas Toussaint, Mario M. Leitao, Martee L. Hensley, Robert A. Soslow, Ginger J. Gardner, Elizabeth L. Jewell

Research output: Contribution to journalArticle

Abstract

Objectives Uterine adenosarcomas (AS) are rare tumors composed of malignant stromal and benign epithelial components. We sought to evaluate the role of primary surgery, adjuvant treatments, and salvage therapies for patients with uterine adenosarcomas. Methods We identified all patients diagnosed with AS from 1990 to 2009 at our institution. Patient demographics, surgical procedures, sites of metastatic disease, and histologic features (e.g., presence of sarcomatous overgrowth, and heterologous elements) were collected. Treatment regimens and survival outcomes were evaluated. Results Thirty-one patients were evaluable for this study: 19 (61%) received up-front treatment at our institution and 12 (39%) received treatment for recurrent disease. Most of the up-front treated patients (15, 79%) were diagnosed with stage I disease and underwent hysterectomy (100%) with bilateral salpingo-oophorectomy (84%). Of the 19 patients treated at our institution from time of initial diagnosis, 5 (26%) patients recurred (median follow-up, 72.9 months; range, 3-154). In 5 patients with sarcomatous overgrowth (AS + SO), the 2-year progression-free and overall survival rates were both 20% versus 100% for 14 patients without sarcomatous overgrowth. Responses to systemic treatment of measurable disease were observed in patients with and without sarcomatous overgrowth, but no optimal treatment strategy could be identified for either groups. Conclusions Unlike AS without sarcomatous overgrowth, AS + SO is an aggressive disease with a high recurrence rate. In our series, no optimal adjuvant or systemic treatment strategy was identifiable but standard sarcoma chemotherapy regimens appear to have efficacy in both AS and AS + SO.

Original languageEnglish (US)
Pages (from-to)140-144
Number of pages5
JournalGynecologic Oncology
Volume129
Issue number1
DOIs
StatePublished - Apr 2013
Externally publishedYes

Fingerprint

Adenosarcoma
Therapeutics
Adenosarcoma of the uterus
Salvage Therapy
Ovariectomy
Hysterectomy
Sarcoma
Disease-Free Survival
Survival Rate
Demography
Recurrence
Drug Therapy
Survival

Keywords

  • Chemotherapy
  • Surgery
  • Uterine adenosarcoma

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Tanner, E. J., Toussaint, T., Leitao, M. M., Hensley, M. L., Soslow, R. A., Gardner, G. J., & Jewell, E. L. (2013). Management of uterine adenosarcomas with and without sarcomatous overgrowth. Gynecologic Oncology, 129(1), 140-144. https://doi.org/10.1016/j.ygyno.2012.12.036

Management of uterine adenosarcomas with and without sarcomatous overgrowth. / Tanner, Edward J.; Toussaint, Thomas; Leitao, Mario M.; Hensley, Martee L.; Soslow, Robert A.; Gardner, Ginger J.; Jewell, Elizabeth L.

In: Gynecologic Oncology, Vol. 129, No. 1, 04.2013, p. 140-144.

Research output: Contribution to journalArticle

Tanner, EJ, Toussaint, T, Leitao, MM, Hensley, ML, Soslow, RA, Gardner, GJ & Jewell, EL 2013, 'Management of uterine adenosarcomas with and without sarcomatous overgrowth', Gynecologic Oncology, vol. 129, no. 1, pp. 140-144. https://doi.org/10.1016/j.ygyno.2012.12.036
Tanner EJ, Toussaint T, Leitao MM, Hensley ML, Soslow RA, Gardner GJ et al. Management of uterine adenosarcomas with and without sarcomatous overgrowth. Gynecologic Oncology. 2013 Apr;129(1):140-144. https://doi.org/10.1016/j.ygyno.2012.12.036
Tanner, Edward J. ; Toussaint, Thomas ; Leitao, Mario M. ; Hensley, Martee L. ; Soslow, Robert A. ; Gardner, Ginger J. ; Jewell, Elizabeth L. / Management of uterine adenosarcomas with and without sarcomatous overgrowth. In: Gynecologic Oncology. 2013 ; Vol. 129, No. 1. pp. 140-144.
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abstract = "Objectives Uterine adenosarcomas (AS) are rare tumors composed of malignant stromal and benign epithelial components. We sought to evaluate the role of primary surgery, adjuvant treatments, and salvage therapies for patients with uterine adenosarcomas. Methods We identified all patients diagnosed with AS from 1990 to 2009 at our institution. Patient demographics, surgical procedures, sites of metastatic disease, and histologic features (e.g., presence of sarcomatous overgrowth, and heterologous elements) were collected. Treatment regimens and survival outcomes were evaluated. Results Thirty-one patients were evaluable for this study: 19 (61{\%}) received up-front treatment at our institution and 12 (39{\%}) received treatment for recurrent disease. Most of the up-front treated patients (15, 79{\%}) were diagnosed with stage I disease and underwent hysterectomy (100{\%}) with bilateral salpingo-oophorectomy (84{\%}). Of the 19 patients treated at our institution from time of initial diagnosis, 5 (26{\%}) patients recurred (median follow-up, 72.9 months; range, 3-154). In 5 patients with sarcomatous overgrowth (AS + SO), the 2-year progression-free and overall survival rates were both 20{\%} versus 100{\%} for 14 patients without sarcomatous overgrowth. Responses to systemic treatment of measurable disease were observed in patients with and without sarcomatous overgrowth, but no optimal treatment strategy could be identified for either groups. Conclusions Unlike AS without sarcomatous overgrowth, AS + SO is an aggressive disease with a high recurrence rate. In our series, no optimal adjuvant or systemic treatment strategy was identifiable but standard sarcoma chemotherapy regimens appear to have efficacy in both AS and AS + SO.",
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