Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Gynecol Oncol. 2013 Apr;129(1):140-4. doi: 10.1016/j.ygyno.2012.12.036. Epub 2012 Dec 30.
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.
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.
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.
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.
子宫腺肉瘤（AS）是一种罕见的肿瘤，由恶性间质和良性上皮成分组成。我们旨在评估原发性手术、辅助治疗和挽救性治疗在子宫腺肉瘤患者中的作用。
我们在我院确定了 1990 年至 2009 年间所有诊断为 AS 的患者。收集患者的人口统计学数据、手术过程、转移性疾病部位和组织学特征（例如肉瘤过度生长和异源成分的存在）。评估治疗方案和生存结局。
本研究共 31 例患者可评估：19 例（61%）在我院接受了初始治疗，12 例（39%）接受了复发性疾病的治疗。大多数接受初始治疗的患者（15 例，79%）诊断为 I 期疾病，接受了子宫切除术（100%）和双侧输卵管卵巢切除术（84%）。在我院从初始诊断开始治疗的 19 例患者中，有 5 例（26%）患者复发（中位随访时间为 72.9 个月；范围为 3-154 个月）。在 5 例存在肉瘤性过度生长的患者（AS+SO）中，肉瘤性过度生长患者的 2 年无进展生存率和总生存率分别为 20%和 100%，而无肉瘤性过度生长的患者分别为 14 例。肉瘤性过度生长和无肉瘤性过度生长的患者均可观察到针对可测量疾病的系统治疗反应，但无法确定任何最佳的治疗策略。
与无肉瘤性过度生长的 AS 不同，AS+SO 是一种侵袭性疾病，复发率高。在我们的研究中，没有确定最佳的辅助或系统治疗策略，但标准的肉瘤化疗方案似乎对 AS 和 AS+SO 都有效。
