96 Adjuvant treatment for adenosarcoma confined to the uterus provides no survival benefit
2020
Introduction Aim of the present study was to investigate patterns of use and outcomes of adjuvant treatment for patients with stage I adenosarcoma. Methods Patients diagnosed between 2004–2015 with stage I adenosarcoma without a history of another tumor who underwent hysterectomy with lymphadenectomy and had at least one month of follow-up were drawn from the National Cancer Database. Patients who received adjuvant chemotherapy (CT) and/or radiotherapy (RT) defined as treatment within 6 months from surgery were identified. Overall survival (OS) was evaluated after generation of Kaplan-Meier curves and compared with the log-rank test. A Cox model was constructed to control for confounders. Results Among 735 patients with stage I adenosarcoma, 186 (25.3%) received adjuvant treatment; 61.3% RT only, 26.9% CT only and 11.8% both RT and CT. Rate of adjuvant treatment was 14.1% for patients with stage IA compared to 35.8% and 53.3% for those with stage IB and IC, p 0.05. Five year OS rate for patients who did not receive adjuvant treatment was 79.9% compared to 63.4%, 68.8% and 74.1% for those who received RT only, CT only and both CT and RT, p=0.002. After controlling for substage, patient age, insurance status and co-morbidities, administration of adjuvant treatment was not associated with a survival benefit (HR: 1.29, 95% CI: 0.92, 1.58) Conclusions There is no clear benefit in the use of adjuvant treatment for patients with early stage adenosarcoma.
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