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World J Surg Oncol. 2017 Apr 19;15(1):87. doi: 10.1186/s12957-017-1137-0.

Feasibility of uterine preservation in the management of early-stage uterine adenosarcomas: a single institute experience.

Author information

1
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea.
2
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea. kdyog@amc.seoul.kr.

Abstract

BACKGROUND:

We aimed to evaluate the efficacy and the safety of uterine preservation in patients with early-stage uterine adenosarcoma who want to preserve future fertility.

METHODS:

We performed a retrospective review of patients with stage I uterine adenosarcoma diagnosed and treated at a single institute from 1998 through 2014.

RESULTS:

Among the total of 31 patients, uterine preservation surgery was performed in 7 of the nulliparas. Of the 7 patients receiving uterine preservation surgery, 3 showed no evidence of disease (NED), 2 had persistent disease confined to the uterus, and 2 were alive with disease (AWD) after recurrence. One patient with an NED status had a vaginal delivery at term. In the uterine preservation group, 1 patient had sarcomatous overgrowth at the time of diagnosis and experienced disease recurrence. In the hysterectomy group, 3 of 24 patients had tumor recurrence. Of the five patients with tumor recurrence, four (80%) had sarcomatous overgrowth at diagnosis and it was significantly associated with recurrence by univariate analysis (OR 13.3, pā€‰=ā€‰0.027).

CONCLUSIONS:

Uterine preservation represents a possible treatment option for young female patients who want to maintain fertility. However, a detailed explanation of the risk of recurrence is necessary, especially in patients with sarcomatous overgrowth, which seems to be associated with a higher risk of recurrence.

TRIAL REGISTRATION:

Retrospectively registered.

KEYWORDS:

Fertility preservation; Mullerian adenosarcoma of the uterus; Uterine adenosarcoma

PMID:
28424089
PMCID:
PMC5395796
DOI:
10.1186/s12957-017-1137-0
[Indexed for MEDLINE]
Free PMC Article

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