Uterine adenosarcoma — statistics sheet¶
Last curated: 2026-10-31
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 retrieved through live PubMed E-utilities. 2026-10-31 figures from Dave PMID 42951232 are from the live abstract (AJOG full text not served).
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 |
| 54 new uterine adenosarcomas vs 533 uterine sarcomas in 2023 | JSOG annual registry, 2023 treatment-start | Kajiyama 2026, PMID 42706489 |
| 1,884 adenosarcomas among 14,801 mesenchymal uterine sarcomas (12.7%) | SEER 22, 2000–2019, age ≥20, microscopically confirmed; LMS 7,883, ESS 3,948, sarcoma NOS 837, undifferentiated 249; carcinosarcoma not listed in this histotype set | Dave 2026, PMID 42951232 (abstract; full text not retrieved) |
| Hysterectomy-corrected incidence 0.1 per 100,000 (adenosarcoma); 0.6 LMS; 0.3 ESS | Same SEER 22 extract | Dave 2026, PMID 42951232 (abstract) |
263 PubMed records for uterine adenosarcoma |
E-utilities esearch 2026-10-31 | this sweep |
| 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. Dave 2026 is the first retrieved hysterectomy-corrected rate (0.1 per 100,000) and remains a SEER extract without central review (PMID 42951232).
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 |
| 19/43 (44.1%); defined as sarcomatous component more than 25% | Seven-centre Turkish cohort, no central review | Aytekin 2026, PMID 42794871 |
| “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 |
| 5-year relative survival 78.3% (75.7–80.6%), adenosarcoma, all stages | SEER 22 2000–2019, Ederer II; no central review; adenosarcoma-specific stage split not in the retrieved abstract | Dave 2026, PMID 42951232 (abstract) |
| 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 |
| 5-year DFS 59.9%; 5-year OS 80.4%; recurrence 15/43 (34.9%); 10 deaths | Seven-centre Turkish cohort n=43, median follow-up 72 months, no central review | Aytekin 2026, PMID 42794871 |
| SO multivariable HR DFS 4.41 (1.21–16.08); OS 10.23 (1.16–89.80, wide CI, 10 events) | Same | Aytekin 2026, PMID 42794871 |
| LVSI multivariable HR OS 11.17 (1.34–93.14); DFS 4.57 (0.77–27.10, p=0.094) | Same | Aytekin 2026, PMID 42794871 |
| 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 |
| Recurrence 15/43 (34.9%); pelvis 9/15, thorax 3/15 | Seven-centre Turkish cohort | Aytekin 2026, PMID 42794871 |
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 |
| Nodal involvement 4/43 (9.3%) of cohort; 22/43 had lymphadenectomy | Seven-centre Turkish cohort | Aytekin 2026, PMID 42794871 |
| 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 (designs labelled)¶
| 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 |
| FUCHSia: 1 adenosarcoma among 15 analysed; that patient had a PR | Single-arm phase 2 fulvestrant; low-grade adenosarcoma without SO; n=1, not an efficacy estimate | Trozzi 2024, PMID 38724237; Table 1 and Efficacy section, full paper retrieved via EudraCT 2026-10-24 |
The studies above are not randomised. OS from first-line chemo did not differ by regimen in Nathenson 2017.
Mixed-histology randomised maintenance results¶
| Figure | Population / method | Source |
|---|---|---|
| EORTC 62113: 59 randomised (30 cabozantinib, 29 placebo); alive without progression at 4 months 13 vs 12, one-sided Fisher p=0.544 | High-grade uterine sarcoma, maintenance after chemotherapy; no histology-specific baseline counts in this results record. ClinicalTrials.gov instead reports actual n=58 and no posted results; discrepancy unresolved. | NCT01979393; EudraCT — “2013-000762-11 clinical trial results”, https://www.clinicaltrialsregister.eu/ctr-search/trial/2013-000762-11/results, first published 2026-06-18, accessed 2026-10-24; primary endpoint table |
These mixed-histology results do not establish an adenosarcoma-specific effect.
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.