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Co-existence of leiomyomas, adenomyosis and endometriosis in women with endometrial cancer.

ABSTRACT: Leiomyomas, adenomyosis, and endometriosis are reported to be risk factors for endometrial carcinoma (EC), and adenomyosis and endometriosis also for ovarian carcinoma (OC). We aimed to describe the prevalence of these conditions in EC patients with or without an OC diagnosis, and to investigate their relationship with EC risk and prognostic factors in these patients. We evaluated the co-existence of these three conditions in 1399 EC patients, and compared the prevalence of epidemiological risk factors and tumor prognostic features in patients with each condition versus not. Prevalence of conditions was also assessed in the subset of patients with prior/concurrent OC. The observed coexistence of leiomyomas, adenomyosis and endometriosis significantly deviated from that expected (P?=?1.2?×?10-8). Patients were more likely to: report a younger age at menarche (PTrend?=?0.004) if they had leiomyomas; have used oral contraceptives (P?=?6.6?×?10-5) or had ?2 full-term pregnancies (PTrend?=?2.0?×?10-9) if they had adenomyosis; be diagnosed with EC at younger age (P?=?5.0?×?10-11) if they had endometriosis. Patients with prior/concurrent OC were more likely to be diagnosed at younger age (P?=?5.0?×?10-5), have endometriosis (P?=?9.9?×?10-7), and present with higher stage EC (PTrend?=?6.6?×?10-5). These findings justify further consideration of these gynecologic conditions as independent risk and prognostic factors for EC.

SUBMITTER: Johnatty SE

PROVIDER: S-EPMC7046700 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Co-existence of leiomyomas, adenomyosis and endometriosis in women with endometrial cancer.

Johnatty Sharon E SE Stewart Colin J R CJR Smith Deborah D Nguyen Anthony A O' Dwyer John J O'Mara Tracy A TA Webb Penelope M PM Spurdle Amanda B AB

Scientific reports 20200227 1

Leiomyomas, adenomyosis, and endometriosis are reported to be risk factors for endometrial carcinoma (EC), and adenomyosis and endometriosis also for ovarian carcinoma (OC). We aimed to describe the prevalence of these conditions in EC patients with or without an OC diagnosis, and to investigate their relationship with EC risk and prognostic factors in these patients. We evaluated the co-existence of these three conditions in 1399 EC patients, and compared the prevalence of epidemiological risk ...[more]

PMID: 32108150

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Project description:BackgroundUterine leiomyomas and adenomyosis are both common and often associated with abnormal uterine bleeding (AUB), including the symptom of heavy menstrual bleeding (HMB). Understanding the prevalence of adenomyosis in women with uterine leiomyomas could inform clinicians and patients in a way that may improve therapeutic approaches.ObjectiveTo explore the prevalence of adenomyosis in a group of women who underwent hysterectomy for AUB-L, to determine the prevalence of submucous leiomyomas, and to examine the utility of preoperative ultrasound to detect the presence of adenomyosis.MethodsThe Kaiser Permanente Hysterectomy Database (KPHD) was searched for women aged 18-52 undergoing hysterectomy for leiomyoma-associated chronic AUB (AUB-L) in 2018 and 2019. A target sample of 400 comprised those with at least 3 years in the Health System. Radiologists evaluated preoperative pelvic ultrasound images to determine leiomyoma size and level 2 FIGO type (submucous or other), and the linked electronic medical record abstracted for clinical features, including histopathological evidence of adenomyosis.ResultsOf the 370 subjects that met the study criteria, adenomyosis was identified via histopathology in 170 (45.9%). There was no difference in the adenomyosis prevalence with (47.1%) and without (43.0%) at least one submucous leiomyoma. Subgroup analysis of ultrasound images by an expert radiologist for the presence of adenomyosis demonstrated a positive predictive value of 54.0% and a negative predictive value of 43.4%.ConclusionsAdenomyosis was present in almost half of this AUB-L cohort undergoing hysterectomy and was equally prevalent in those with and without submucous leiomyomas as determined by sonographic evaluation. The imaging findings are in accord with prior investigators and demonstrate that 2-D ultrasound is insensitive to the presence of adenomyosis when the uterus is affected by leiomyomas. Further research is necessary to determine the impact of various adenomyosis phenotypes on the presence and severity of the symptom of HMB.

Dataset Information

Co-existence of leiomyomas, adenomyosis and endometriosis in women with endometrial cancer.

Publications

Co-existence of leiomyomas, adenomyosis and endometriosis in women with endometrial cancer.

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