Introduction Uterine Adenosarcomas (UAS) are rare mixed biphasic tumors of benign endometrial glands and a malignant mesenchymal component. A sarcomatous overgrowth (SO) should be associated with a more aggressive form in the usually low-grade tumors. For Germany there is practically no data concerning surgical methods and the prognostic relevance of the SO. Based on an appropriate case series we present an analyzation of survival data for the UAS. These also include the dependence on the SO. Methods Based on the DKSM data base, 53 patients with UAS were analyzed in a mixed retrospective and prospective review from July 2008 to June 2017. The further course of the disease was evaluated by a questionnaire. The Kaplan-Meier method was used to determine overall survival (OS), disease specific survival and recurrence free interval (RFI). The survival curves were compared with the log-rank test, assuming a significance level of p = 0.005. Results The median age of all women was 56 years. The median age of women with AS-SO was 57 years. Therefore, they became diseased later than women with no SO. The majority of tumors were diagnosed at a stage FIGO IB. The most patients received a total hysterectomy (HE) with bilateral adnexectomy. In advanced stages, a radical HE often occurred. Radical and total hysterectomy appeared to be equivalent in terms of OS and RFI. Tumor-specific survival for AS-OS is significantly longer with median 51 compared to AS-SO with 23 months. This is also ...