{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:09:07Z","timestamp":1788869347806,"version":"build-2803163510"},"reference-count":30,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives:\u00a0Uterine adenosarcoma is a rare uterine malignancy with limited evidence on prognostic factors and long-term outcomes. We aimed to evaluate clinicopathological characteristics, treatment patterns, oncologic outcomes, and prognostic factors associated with disease-free survival (DFS) and overall survival (OS) in patients with uterine adenosarcoma. Methods: This multicenter retrospective cohort study included 43 patients with histopathologically confirmed uterine adenosarcoma who underwent primary surgery at seven tertiary referral centers in T\u00fcrkiye between 2016 and 2026. Clinicopathological features, treatment modalities, recurrence patterns, and survival outcomes were assessed. Survival was analyzed using Kaplan\u2013Meier and log-rank methods, and multivariable Cox proportional hazards regression was performed to identify independent prognostic factors. Results: The mean age at diagnosis was 59.1 \u00b1 10.8 years, and 83.7% of patients were postmenopausal. Pelvic pain (62.8%) and abnormal uterine bleeding (60.5%) were the most common presenting symptoms. Most patients (79.1%) underwent laparotomy, and 79.1% had stage I disease. Sarcomatous overgrowth (SO) was present in 44.1% and lymphovascular space invasion (LVSI) in 18.6%. During a median follow-up of 72 months, 34.9% experienced recurrence, most commonly in the pelvis. The five-year DFS and OS rates were 59.9% and 80.4%, respectively. SO was independently associated with DFS (HR 4.41, 95% CI 1.21\u201316.08; p = 0.025) and OS (HR 10.23, 95% CI 1.16\u201389.80; p = 0.036), while LVSI was independently associated with OS (HR 11.17, 95% CI 1.34\u201393.14; p = 0.026). Conclusions: Uterine adenosarcoma showed favorable long-term survival but substantial recurrence risk. SO and LVSI may have potential prognostic relevance and could contribute to postoperative risk assessment and individualized follow-up.<\/jats:p>","DOI":"10.3390\/cancers18182903","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:23:51Z","timestamp":1788866631000},"page":"2903","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes and Prognostic Factors in Uterine Adenosarcoma: A Multicenter Retrospective Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1039-3082","authenticated-orcid":false,"given":"Atacem Mert","family":"Aytekin","sequence":"first","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098\u00a0Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5645-7064","authenticated-orcid":false,"given":"Ipek Betul","family":"Ozcivit Erkan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Seyma","family":"Okumus","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098 Istanbul, T\u00fcrkiye"},{"name":"Department of Obstetrics and Gynecology, Health Sciences University, Istanbul Training and Research Hospital, 34098 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Bilgehan","family":"Saglik","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098\u00a0Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4081-1081","authenticated-orcid":false,"given":"Ayse","family":"Yavuz","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098\u00a0Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1377-2651","authenticated-orcid":false,"given":"Utku","family":"Akgor","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hacettepe University, 06230 Ankara, 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T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0163-1141","authenticated-orcid":false,"given":"Ghanim","family":"Khatib","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cukurova University Faculty of Medicine, 01330 Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7337-9977","authenticated-orcid":false,"given":"Ilkbal Temel","family":"Yuksel","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, 34480 Istanbul, 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34098\u00a0Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"694","DOI":"10.3109\/0284186X.2012.689111","article-title":"Diagnosis and treatment of sarcoma of the uterus. 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Cancer"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/18\/2903\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:28:52Z","timestamp":1788866932000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/18\/2903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,8]]},"references-count":30,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["cancers18182903"],"URL":"https:\/\/doi.org\/10.3390\/cancers18182903","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,8]]}}}