Clinical practice guidelines registry — uterine adenosarcoma¶

Last curated: 2026-09-01

Purpose. Catalog of documents that govern (or are cited as governing) the diagnosis and management of uterine adenosarcoma. Most are uterine-sarcoma or soft-tissue-sarcoma guidelines with an adenosarcoma subsection or a silent gap. The synthesis of what they recommend lives in wiki/guidelines.md and is not duplicated here. Every PMID was independently re-fetched through PubMed E-utilities on 2026-09-01; web-only sources carry URL and access date.

How to read status. current = newest of its lineage and scope; current (aging) = newest of lineage but old; superseded by → = replaced by a named successor; staging = a staging document; consensus-review = GCIG-style review functioning as guidance; adjacent = covers uterine sarcoma or STS generally, adenosarcoma not specified; insights-only = published delta, not the full guideline.

1. Master table¶

#	Society / body	Year	Region	Scope	Citation + PMID/URL	Status
1	ESGO / EURACAN / GCIG	2024	Europe / international	Uterine sarcomas including an adenosarcoma subsection	Ray-Coquard et al., Int J Gynecol Cancer 2024;34:1499–1521. PMID 39322612	current
2	French Sarcoma Group + Rare Gynecologic Tumor Group	2023	France	Dedicated uterine adenosarcoma guideline	Karabajakian et al., Bull Cancer 2023;110:836–843. PMID 37202293	current
3	GCIG	2014	International	Dedicated Müllerian adenosarcoma consensus review	Friedlander et al., Int J Gynecol Cancer 2014;24:S78–82. PMID 25341585	current (aging) consensus-review
4	FIGO	2009	Global	Staging of uterine sarcomas (adenosarcoma-specific stage I)	Prat, Int J Gynaecol Obstet 2009;104:177–8. PMID 19135669	current staging
5	NCCN Uterine Neoplasms, Insights v3.2025	2025	USA	Insights paper: FIGO 2023 endometrial staging + endometrial systemic therapy	Abu-Rustum et al., J Natl Compr Canc Netw 2025;23:284–291. PMID 40763788	insights-only; parent NCCN sarcoma chapter not retrieved as full text this session
6	ESMO–EURACAN–GENTURIS	2021	Europe	Soft tissue and visceral sarcomas	Gronchi et al., Ann Oncol 2021;32:1348–1365. PMID 34303806	current for STS; adjacent for adenosarcoma
7	ESMO	2012	Europe	Soft tissue and visceral sarcomas	Ann Oncol 2012;23 Suppl 7:vii92–9. PMID 22997462	superseded by → #6
8	ESMO	2008	Europe	Soft tissue sarcomas	Casali et al., Ann Oncol 2008;19 Suppl 2:ii89–93. PMID 18456783	superseded by → #7
9	SIGO (Italian consensus)	2020	Italy	Uterine sarcomas as a class	Ferrandina et al., Eur J Cancer 2020;139:149–168. PMID 32992154	current national consensus; adjacent
10	Ulrich & Denschlag practical review	2018	Germany-facing	Dedicated short review, not a society CPG	Oncol Res Treat 2018;41:693–696. PMID 30326467	adjacent (review)

ESGO pocket guideline (web PDF derived from #1): ESGO — "Uterine sarcomas pocket guidelines", https://www.esgo.org/media/2025/03/Pocket-Guidelines_UTERINE-sarcomas_tisk.pdf, accessed 2026-09-01.

NCI PDQ patient uterine sarcoma page (includes adenosarcoma staging): NCI — "Uterine Sarcoma Treatment (PDQ)", https://www.cancer.gov/types/uterine/patient/uterine-sarcoma-treatment-pdq, accessed 2026-09-01.

2. Per-guideline entries¶

2.1 — ESGO/EURACAN/GCIG 2024 (PMID 39322612)¶

Scope: uterine sarcomas — LMS, HG-ESS, UUS, LG-ESS, adenosarcoma, selected rare entities. Imaging, pathology, molecular analysis, surgery, radiation, systemic therapy, follow-up.
Adenosarcoma-specific (from the published paper plus the ESGO pocket PDF fetched this session): adjuvant endocrine therapy not recommended for stage I; adjuvant RT not recommended for stage I; post-operative chemotherapy not standard for stage I; adjuvant chemotherapy can be considered as an option in stage II, III–IV completely resected disease; after morcellation of high-grade/SO tumour, post-operative chemotherapy could be considered; endocrine therapy (AI, progestogen, or GnRH analogue) for recurrent/metastatic ER/PR-positive low-grade adenosarcoma; tamoxifen should not be given (agonist risk).
Evidence base: retrospective series and expert consensus. No reported adenosarcoma-specific randomised outcome is cited; the older mixed-histology phase 3 registration NCT00162721 has unknown status and no posted results.
Predecessor: GCIG 2014 dedicated adenosarcoma review (#3); ESGO had not previously issued a combined uterine-sarcoma CPG of this scope.

2.2 — French GSF / TMRG 2023 (PMID 37202293)¶

Scope: dedicated uterine adenosarcoma. French-language society guideline.
Unique contribution: the only current document whose title is uterine adenosarcoma. Defines SO as sarcomatous contingent occupying >25% of tumour volume, “directly correlated to the grade.” Stage I without SO: 5-year OS up to 80%. Complete surgical removal in localised disease. Role of hormone therapy, chemotherapy and adjuvant RT not established. Relapses re-treated surgically if complete resection possible. Hormone therapy an option for ER/PR-overexpressing low-grade advanced disease; doxorubicin-based combinations for high-grade inoperable/metastatic.
Relationship to ESGO 2024: same evidence, slightly less permissive adjuvant wording.

2.3 — GCIG 2014 (PMID 25341585)¶

Scope: Müllerian adenosarcoma of the female genital tract.
Contribution: 5% of uterine sarcomas; postmenopausal; midway between adenofibroma and carcinosarcoma; good prognosis except deep invasion or high-grade SO; extrauterine adenosarcoma higher recurrence risk; stated that there were no clinical trials; management recommendations from expert consensus. The 2026-09-01 registry audit found an older mixed-histology phase 3 registration (NCT00162721), but it has unknown status and no posted results, so the consensus review remains correct about the absence of trial evidence while its literal “no trials” wording is too broad.
Status: not formally retired; ESGO 2024 is the operational European successor for management.

2.4 — FIGO 2009 staging (PMID 19135669)¶

Scope: staging of uterine sarcomas, with adenosarcoma stage I based on myometrial invasion (IA none, IB ≤½, IC >½) rather than size.
Erratum: Int J Gynaecol Obstet 2009;106:277.
Status: still the sarcoma staging system; NCCN Insights 2025 is about FIGO 2023 endometrial staging and does not replace this.

2.5 — NCCN Insights v3.2025 (PMID 40763788)¶

Scope of this paper: FIGO 2023 endometrial staging and endometrial systemic-therapy updates. Uterine sarcoma is in the parent Uterine Neoplasms guideline; the Insights abstract does not update sarcoma-specific recommendations.
Dated access gap: on 2026-09-01 both official NCCN uterine guideline PDF endpoints returned HTML sign-in pages rather than the guideline. No parent-guideline adenosarcoma recommendation is asserted here beyond the verified scope of the Insights paper.

2.6 — ESMO STS lineage (PMIDs: 34303806, 22997462, 18456783)¶

Scope: soft tissue and visceral sarcomas. Relevant for class-level systemic agents (doxorubicin, trabectedin, pazopanib) and follow-up cadence. Not an adenosarcoma management guideline.

2.7 — SIGO 2020 (PMID 32992154)¶

Italian national consensus on uterine sarcomas as a class, motivated by inability to run prospective trials in rare histotypes.

3. Disagreements and gaps¶

Adjuvant chemotherapy in resected high-risk disease. ESGO “option” (stage II–IV; morcellated high-grade/SO) vs French “not established” vs Nathenson review “candidates.” Same empty evidence.
Ovarian preservation. Guidelines default to BSO; SEER/institutional data are underpowered for adenosarcoma (PMID 28541635, 35005157). Guidelines are silent rather than opposed.
Surveillance interval. None specifies an adenosarcoma schedule despite Clement’s late recurrences (PMID 2156771).
No US dedicated document. SGO has not issued a histology-specific adenosarcoma guideline retrieved this session.
NCCN sarcoma chapter content not independently verified this session beyond the 2025 Insights paper’s endometrial focus.

4. Watch list¶

ESGO update after 2024.
NCCN Uterine Neoplasms full guideline version after v3.2025, sarcoma algorithm.
FUCHSia (NCT03926936) results publication.
Any GCIG or EURACAN adjuvant protocol in stage I SO.