Uterine adenosarcoma — statistics sheet¶
Last curated: 2026-09-01
Purpose. Source-locked figures: incidence shares, age, stage, survival, recurrence, nodal rates, occult-sarcoma denominators. Every figure carries source, year, population, and method. Conflicting estimates are shown side by side, never averaged. Registry figures lack sarcomatous overgrowth and central pathology review; institutional figures are referral-biased. All cited PMIDs were independently re-fetched through PubMed E-utilities on 2026-09-01.
How to cite. Carry the PMID forward with the figure. Never cite “the statistics sheet” as the source.
1. How rare¶
| Figure | Population / method | Source |
|---|---|---|
| ~5% of uterine sarcomas | Review synthesis | Nathenson 2016, PMID 27718181; Friedlander 2014, PMID 25341585 |
| 5–8% of uterine sarcomas | Review introducing a fertility-sparing case | L'Heveder 2019, PMID 31584132 |
| 0.43% of uterine cancers; 0.16% of cervical; 0.04% of ovarian | NCDB 1998–2011: 1,884 uterine / 229 cervical / 92 ovarian adenosarcomas | Seagle 2016, PMID 27771166 |
| 544 adenosarcomas among 5,496 SEER “sarcoma” registrations that include carcinosarcoma (10%) | SEER 1988–2006 | Arend 2010, PMID 20688363 |
| 994 uterine adenosarcomas | SEER 1973–2013 | Machida 2017, PMID 28109626 |
| 797 in a survival model | SEER | Qu 2020, PMID 33680946 |
| 41 new uterine adenosarcomas vs 366 uterine sarcomas in 2017 (≈11% of that year’s registered uterine sarcoma) | JSOG annual registry | Nagase 2021, PMID 33631867 |
258 PubMed records for uterine adenosarcoma |
E-utilities esearch 2026-09-01 | independent audit session |
| Age-adjusted uterine sarcoma incidence 7 vs 3.6 vs 2.7 per 100,000 (Black vs White vs other); difference driven by LMS and carcinosarcoma, not adenosarcoma | SEER 1989–1999, n=2,677 uterine sarcomas | Brooks 2004, PMID 15047237 |
No paper retrieved this session reports a population incidence of uterine adenosarcoma per 100,000 women with central pathology review.
2. Age and site¶
| Figure | Population | Source |
|---|---|---|
| Median age 58 (range 14–89) | 100-case expert series | Clement 1990, PMID 2156771 |
| Mean age 50 (range 13–83); 37 corpus, 11 cervix, 4 ovary | 55-case series | Gallardo 2009, PMID 18941402 |
| Median 47.5 (19–75); 38.9% cervical | 49-case single centre | Yuan 2019, PMID 31139558 |
| Median 51 (IQR 41–68); 74.2% corpus, 22.6% cervix | 31-case single centre | Li 2022, PMID 35005157 |
| MRI-review median 48.5 (9–79) | 30 imaging cases | Morikawa 2025, PMID 39729099 |
Younger medians in recent surgical series are referral/cervical-mix effects, not a documented falling incidence age.
3. Stage and invasion¶
| Figure | Population | Source |
|---|---|---|
| Myometrial invasion 15/100, deep in 4 | Clement 100 | Clement 1990, PMID 2156771 |
| Myometrial invasion 14/30 uterine (47%): minimal 5, ⅓ thickness 7, >50% 2 | Gallardo uterine subset | Gallardo 2009, PMID 18941402 |
| Of 30 uterine-corpus with known stage: 17 IA, 11 IB, 1 IC, 1 IIIC | Gallardo | Gallardo 2009, PMID 18941402 |
| Majority early-stage vs carcinosarcoma | SEER 544 adenosarcomas | Arend 2010, PMID 20688363 |
| Pathological T1 in 85.2% of MRI-reviewed cases | Morikawa imaging set | Morikawa 2025, PMID 39729099 |
FIGO 2009 adenosarcoma IA = no myometrial invasion; IB ≤½; IC >½ (Prat 2009, PMID 19135669). Do not apply LMS/ESS size-based stage I.
4. Sarcomatous overgrowth frequency¶
| Figure | Design | Source |
|---|---|---|
| 17/31 (55%) | GOG hysterectomy + staging laparotomy | Kaku 1992, PMID 1316323 |
| 18/55 (33%) | Clinicopathologic series | Gallardo 2009, PMID 18941402 |
| 5/19 (26%) up-front treated | MSK treatment series | Tanner 2013, PMID 23283300 |
| 15/49 (30.6%) | Single-centre 12-year | Yuan 2019, PMID 31139558 |
| 55.2% | MRI systematic review (imaging-selected) | Morikawa 2025, PMID 39729099 |
| “about 10% of cases” | Practical review | Ulrich 2018, PMID 30326467 |
The spread reflects different series designs and case mixes; these estimates should be shown side by side rather than collapsed into a single prevalence estimate.
5. Survival¶
| Figure | Population | Source |
|---|---|---|
| Stage I 5-year 79% (75–84%); stage III 48% (29–65%) | SEER adenosarcoma 1988–2006 | Arend 2010, PMID 20688363 |
| HR of death vs carcinosarcoma 0.35 (0.28–0.45) | SEER multivariable | Arend 2010, PMID 20688363 |
| Survival with uterine-wall invasion 63–69%; extra-uterine <50% | SEER | Arend 2010, PMID 20688363 |
| Stage I 5-year OS without SO up to 80% | Guideline synthesis | Karabajakian 2023, PMID 37202293; Ulrich 2018, PMID 30326467 |
| Stage I 5-year OS overall 60–80%; with SO 50–60% | Review | Nathenson 2016, PMID 27718181 |
| Median OS all-comers 8.5 years; DFS 4.7 years | MDACC n=165 | Nathenson 2018, PMID 30044322 |
| Median OS with SO 5.2 vs 14.5 years (p<0.0001) | MDACC n=165 | Nathenson 2018, PMID 30044322 |
| Median OS with invasion 5.8 years vs not reached (p=0.0005) | MDACC n=165 | Nathenson 2018, PMID 30044322 |
| Median OS with LVSI 1.0 vs 8.9 years (p=0.0021) | MDACC n=165 | Nathenson 2018, PMID 30044322 |
| Median PFS 29.4 vs 105.9 months (HR 2.58, 1.37–4.84); OS 55.4 vs 112.4 months (HR 2.45, 1.26–4.76) by SO | MDACC n=74 | Carroll 2014, PMID 25449308 |
| 2-year PFS and OS 20% with SO vs 100% without | MSK n=19 (5 SO) | Tanner 2013, PMID 23283300 |
| Disease-specific death 34% (29/86); stage IA recurrence 13% (4/30), death 3.3% (1/30) | Japanese literature-assembled n=110 | Tate 2018, PMID 29441675 |
| Deep-learning test c-index 0.774 vs Cox 0.726 | SEER n=797 | Qu 2020, PMID 33680946 |
Tate is publication-biased. Qu is discrimination, not a survival rate. Arend stage I 79% is unstratified by SO.
6. Recurrence¶
| Figure | Population | Source |
|---|---|---|
| 23/100; mean 3.4 years (0.5–9.5); ≥5 years in ⅓ of recurrences; hematogenous in 2 | Clement 100 | Clement 1990, PMID 2156771 |
| 10/25 (40%); median interval 5 years | Zaloudek adenosarcomas | Zaloudek 1981, PMID 6263458 |
| 9/30 (30%); 6/30 (20%) dead at mean 38.3 months | Kaku GOG | Kaku 1992, PMID 1316323 |
| Stage I: 77% (17/22) with SO vs 22% (8/37) without | Carroll | Carroll 2014, PMID 25449308 |
| Review compilation: 23% without SO vs 77% with SO | Nathenson review | Nathenson 2016, PMID 27718181 |
| SO subset: recurrence 45% (9/20), death 35% (7/20); distant 44% of 27 recurrences; lung in 75% of distant | Tate assembled | Tate 2018, PMID 29441675 |
| Median OS from recurrence 1.8 years; surgery for first recurrence 26.3 vs 15.1 months | MDACC n=78 recurrent | Nathenson 2017, PMID 29445312 |
| Recurrence 36.4% in MRI-reviewed set | Morikawa | Morikawa 2025, PMID 39729099 |
7. Nodes, margins, size¶
| Figure | Population | Source |
|---|---|---|
| Nodal metastasis 2.9% adenosarcoma vs 3.4% LMS vs 6.6% ESS | SEER | Machida 2017, PMID 28109626 |
| Nodal aHR for CSS 2.34 (adenosarcoma) | SEER multivariable | Machida 2017, PMID 28109626 |
| Literature-review n=230: nodal aHR for PFS 4.72 vs SO 2.88, heterologous 2.08, deep invasion 1.51 | Machida systematic review of published cases | Machida 2017, PMID 28109626 |
| Nodal 36/1,176 (3.1%); distant 33/1,342 (2.5%) | NCDB | Seagle 2016, PMID 27771166 |
| 0/15 lymphadenectomies positive | Li n=31 | Li 2022, PMID 35005157 |
| Size HR 1.06 per cm (1.01–1.12) | NCDB uterine subset | Seagle 2016, PMID 27771166 |
| Mean size 6.5 cm (1–20) | Gallardo | Gallardo 2009, PMID 18941402 |
| Mean longest MRI diameter 9.3 cm | Morikawa | Morikawa 2025, PMID 39729099 |
8. Systemic therapy (retrospective)¶
| Figure | Population | Source |
|---|---|---|
| RECIST CR+PR 31.2% doxorubicin-based; 14.3% gemcitabine/docetaxel | Recurrent/metastatic n=78, first-line chemo subset | Nathenson 2017, PMID 29445312 |
| Median PFS 15.4 months doxorubicin/ifosfamide vs 5.0 gemcitabine/docetaxel vs 6.5 other doxorubicin vs 5.7 platinum | Same | Nathenson 2017, PMID 29445312 |
| Adjuvant in stage I SO: PFS 46.7 vs 29.4 months (p=0.28); OS 97.3 vs 55.4 (p=0.18) | Carroll | Carroll 2014, PMID 25449308 |
| ER-positive 34/54 (63%) mixed uterine sarcomas; OS 36 vs 16 months | Ioffe mixed histologies | Ioffe 2009, PMID 19767065 |
Not randomised. OS from first-line chemo did not differ by regimen in Nathenson 2017.
9. Occult sarcoma / morcellation (uterine sarcoma as a class)¶
| Figure | Population | Source |
|---|---|---|
| Occult uterine sarcoma 1/278 or 3.60/1,000 (2.97–4.23); occult LMS 1/429 or 2.33/1,000 (1.83–2.84) | 34,728 leiomyoma hysterectomies, Kaiser 2006–2013 | Raine-Bennett 2016, PMID 26646120 |
| Combined morcellation vs none, death at 1 year in stage I LMS: RR 5.12 (1.33–19.76) | Same, n=111 stage I LMS | Raine-Bennett 2016, PMID 26646120 |
| Unexpected sarcoma 0.13% (5/3,759; 0.04–0.31%) of benign-indication hysterectomies; 0.39% (1 in 256) among fibroids; all 4 unexpected fibroid sarcomas were LMS | Olmsted, 4,232 hysterectomies | Multinu 2019, PMID 30447212 |
| Incidence 0.03% uterine weight <250 g vs 15.4% (2/13) ≥2000 g | Same | Multinu 2019, PMID 30447212 |
No adenosarcoma-specific morcellation survival estimate was retrieved. One adenosarcoma+morcellation PubMed hit: Krentel 2016, PMID 27769260 (case report).
10. Molecular frequencies (sequenced series, n small)¶
| Figure | n | Source |
|---|---|---|
| MDM2/CDK4 amp 5/18 (28%); MYBL1 amp 4/18 (22%); PI3K pathway 13/18 (72%); ATRX 3/18 (17%); TP53 2/18, both SO; rearrangements 0/18 | 18 subjects | Howitt 2015, PMID 25231023 |
| Mean gene-level CNVs 24.6 with SO vs 5 without (p=0.0002); mutation count 9.7 vs 9.6 | Same | Howitt 2015, PMID 25231023 |
| TP53 pathway 7/9 (78%) high-grade | 9 high-grade | Hodgson 2017, PMID 28834809 |
| DICER1 18/19 (95%) uterine ERMS vs 7/27 (26%) adenosarcoma | Central-review series | de Kock 2020, PMID 31900434 |
| BAP1 IHC loss 6/24 (25%); BAP1 homdel unique to adenosarcoma among 196 gyn mesenchymal tumours | 27 sequenced, IHC subset | Momeni Boroujeni 2022, PMID 36138078 |
| ESR1 fusions: ESR1::NCOA3 10, ESR1::NCOA2 1, ESR1::MAMLD1 1 | 12 adenosarcoma-like uterine neoplasms; classification relative to conventional adenosarcoma/UTROSCT unresolved | Agaimy 2026, PMID 41555057 |
Known conflicts and caveats¶
- SO frequency 10% vs 55% is series construction, not biology.
- Arend stage I 79% vs Carroll stage I SO 77% recurrence are not the same population; registries cannot see SO.
- Seagle: radiation associated with worse OS vs Nathenson: no OS difference for radiation vs Brooks mixed-sarcoma: radiation plus surgery better in stage II–IV — confounding by indication plus mixed histologies. Do not average.
- Seagle: node status not independent for OS vs Machida: nodal aHR 2.34 for CSS — different registries, endpoints, covariates.
- Tate 34% disease-specific death is a literature-assembled series.
- Morcellation numbers are LMS/uterine-sarcoma-class, not adenosarcoma.
- Ioffe ER 63% is mixed uterine sarcoma.