Min An1, Hua Duan1, Ying Zhang1. 1. Department of Gynecological Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Abstract
OBJECTIVE: Published data on the impact of co-existent adenomyosis on the prognosis of patients with endometrial cancer remains elusive, with studies reporting conflicting results. We conducted this meta-analysis to evaluate the prognostic significance of co-existent adenomyosis on clinical outcomes and tumor characteristics of endometrial cancer patients. METHODS: A comprehensive literature review of multiple databases was conducted; quality assessment of eligible studies was performed by the Newcastle-Ottawa scale (NOS). The outcomes of interest were compared in endometrial cancer patients with or without adenomyosis. Hazards ratios (HR) and Odds ratios (OR) with 95% confidence interval (CI) were calculated as a measure of effects. RESULTS: Fourteen retrospective observational studies comprising 1308 endometrial cancer patients with adenomyosis and 3734 patients without adenomyosis were included in this meta-analysis. Results indicated that endometrial cancer patients with adenomyosis was significantly associated with an increased overall survival rate (HR = 0.51; 95% CI = 0.38-0.69; P < 0.00001), but not with disease-free survival rate (HR = 0.68; 95% CI = 0.30-1.53; P = 0.35); besides, significantly associated with decreased ratio of deep myometrial invasion (OR = 0.45; 95% CI = 0.33-0.60; P < 0.00001), lymphovascular space invasion (OR = 0.44; 95% CI = 0.29-0.68; P = 0.0002), an increased ratio of histological grade 1 (OR = 1.84; 95% CI = 1.34-2.53; P = 0.0002) and FIGO I-II (OR = 1.85; 95% CI = 1.49-2.30; P < 0.00001). However, there was no significant difference in pathological type and lymph node metastasis. There was a low to high heterogeneity with I2 ranging from 0 to 67%. CONCLUSION: This meta-analysis indicated that co-existent adenomyosis with endometrial cancer is associated with favorable tumor characteristics and could serve as a potential protective factor for the prognosis of endometrial cancer.
OBJECTIVE: Published data on the impact of co-existent adenomyosis on the prognosis of patients with endometrial cancer remains elusive, with studies reporting conflicting results. We conducted this meta-analysis to evaluate the prognostic significance of co-existent adenomyosis on clinical outcomes and tumor characteristics of endometrial cancer patients. METHODS: A comprehensive literature review of multiple databases was conducted; quality assessment of eligible studies was performed by the Newcastle-Ottawa scale (NOS). The outcomes of interest were compared in endometrial cancer patients with or without adenomyosis. Hazards ratios (HR) and Odds ratios (OR) with 95% confidence interval (CI) were calculated as a measure of effects. RESULTS: Fourteen retrospective observational studies comprising 1308 endometrial cancer patients with adenomyosis and 3734 patients without adenomyosis were included in this meta-analysis. Results indicated that endometrial cancer patients with adenomyosis was significantly associated with an increased overall survival rate (HR = 0.51; 95% CI = 0.38-0.69; P < 0.00001), but not with disease-free survival rate (HR = 0.68; 95% CI = 0.30-1.53; P = 0.35); besides, significantly associated with decreased ratio of deep myometrial invasion (OR = 0.45; 95% CI = 0.33-0.60; P < 0.00001), lymphovascular space invasion (OR = 0.44; 95% CI = 0.29-0.68; P = 0.0002), an increased ratio of histological grade 1 (OR = 1.84; 95% CI = 1.34-2.53; P = 0.0002) and FIGO I-II (OR = 1.85; 95% CI = 1.49-2.30; P < 0.00001). However, there was no significant difference in pathological type and lymph node metastasis. There was a low to high heterogeneity with I2 ranging from 0 to 67%. CONCLUSION: This meta-analysis indicated that co-existent adenomyosis with endometrial cancer is associated with favorable tumor characteristics and could serve as a potential protective factor for the prognosis of endometrial cancer.
Authors: Marjolein Hermens; Anne M van Altena; Maaike van der Aa; Johan Bulten; Huib A A M van Vliet; Albert G Siebers; Ruud L M Bekkers Journal: Int J Cancer Date: 2021-12-27 Impact factor: 7.316
Authors: Diego Raimondo; Antonio Raffone; Antonio Travaglino; Manuela Maletta; Paolo Casadio; Marco Ambrosio; Anna Chiara Aru; Angela Santoro; Gian Franco Zannoni; Luigi Insabato; Antonio Mollo; Fulvio Zullo; Renato Seracchioli Journal: Int J Gynaecol Obstet Date: 2021-07-18 Impact factor: 4.447