Association Between Adenomyosis and Cervical Cancer: A Retrospective Cohort Study.

Objective: The main purpose of the study was to explore the clinicopathological features and survival outcomes of patients with cervical cancer (CC) and adenomyosis and without the latter and to gain insight into the timely association between adenomyosis and CC.

Methods: 991 patients with CC and adenomyosis and 3964 patients without the latter were included in this retrospective cohort study. The clinicopathological characteristics including tumor size, depth of stromal invasion, presence of lymphovascular space invasion (LVSI), infiltration into vagina or uterine body, status of surgical vaginal margin, parametrial involvement, and pelvic or para-aortic lymph nodes metastasis were compared between the CC patients with/without coexisting adenomyosis by Student's t-tests, chi-square or Fisher's exact tests. The Cox proportional hazards model was employed to evaluate potential risk factors. Survival curves were constructed using the Kaplan-Meier method.

Results: Among the cervical cancer cohort, the coexistence of adenomyosis is associated with a lower likelihood of deep stromal invasion (50.2% vs 54.6%, p < 0.0001) and vaginal infiltration (25.8% vs 29.1%, p = 0.041) compared with CC patients without adenomyosis. There were no significant differences in tumor size, presence of LVSI, uterine body infiltration, status of surgical vaginal margin, parametrial involvement, and pelvic or para-aortic lymph nodes metastasis between both groups. However, adenomyosis did not remain as an independent prognostic factor for CC (HR 0.938, 95% CI: [0.72-1.22], p = 0.636) and did not reach statistical significance in the survival analysis (log rank test, p = 0.587).

Conclusion: CC patients with coexistent adenomyosis were associated with less aggressive tumor behavior including deep stromal invasion and vaginal infiltration. However, adenomyosis was not a prognostic factor for CC survival.