Brooks Sandra E, Zhan Min, Cote Timothy, Baquet Claudia R
Department of Obstetrics and Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Gynecol Oncol. 2004 Apr;93(1):204-8. doi: 10.1016/j.ygyno.2003.12.029.
To determine the association of race with incidence, histology, treatment, and survival in women with uterine sarcoma during the period 1989-1999.
Uterine sarcomas were defined as leiomyosarcoma, carcinosarcoma, high-grade endometrial stromal sarcoma (HGESS), adenosarcoma, and sarcoma not otherwise specified (NOS). We used cases from Surveillance, Epidemiology, and End Results (SEER) program to compare uterine sarcoma among women >35 years of age. Using data from 1989 to 1999, we compared race-specific age-adjusted incidences, histological distributions, extent of disease at diagnosis, and race-specific survival.
During the period of 1989-1999, 2677 women were diagnosed with uterine sarcoma, 2098 (78%) of whom were white and 420 (16%) of whom were black, and 159 (6%) of whom were of other races. The overall age-adjusted incidence for blacks was twice that of whites and more than twice that of women of other races (7/10(5) vs. 3.6/10(5) vs. 2.7/10(5), P < 0.0001). Racial differences in the incidence of uterine sarcoma existed for leiomyosarcoma (1.51/10(5) for blacks vs. 0.91/10(5) for whites, and 0.89 for women of other races, P < 0.01) and carcinosarcoma (4.3/10(5) for blacks, vs. 1.7/10(5) for whites, and 0.99 for women of other races, P < 0.001), but not for other histological types. Blacks with stage II disease were less likely to receive radiation in addition to surgery compared to whites (33% vs. 54%, P < 0.05). Five-year relative survival of patients with disease beyond the uterus was significantly longer for those that received radiation and surgery compared to those that received surgery alone. There were no racial differences in survival for women that received similar therapy.
Adjuvant therapy improved survival for women with stage II-IV disease. Survival of black and white patients who received comparable treatment was similar.
确定1989年至1999年期间子宫肉瘤女性患者的种族与发病率、组织学、治疗及生存率之间的关联。
子宫肉瘤定义为平滑肌肉瘤、癌肉瘤、高级别子宫内膜间质肉瘤（HGESS）、腺肉瘤以及未另行特指的肉瘤（NOS）。我们使用监测、流行病学与最终结果（SEER）项目中的病例，比较35岁以上女性的子宫肉瘤情况。利用1989年至1999年的数据，我们比较了种族特异性年龄调整发病率、组织学分布、诊断时疾病范围以及种族特异性生存率。
在1989年至1999年期间，2677名女性被诊断为子宫肉瘤，其中2098名（78%）为白人，420名（16%）为黑人，159名（6%）为其他种族。黑人的总体年龄调整发病率是白人的两倍，是其他种族女性的两倍多（7/10⁵ 对 3.6/10⁵ 对 2.7/10⁵，P < 0.0001）。子宫肉瘤发病率在平滑肌肉瘤（黑人1.51/10⁵，白人0.91/10⁵，其他种族女性0.89，P < 0.01）和癌肉瘤（黑人4.3/10⁵，白人1.7/10⁵，其他种族女性0.99，P < 0.001）方面存在种族差异，但在其他组织学类型中不存在。与白人相比，患有II期疾病的黑人除手术外接受放疗的可能性较小（33% 对 54%，P < 0.05）。与仅接受手术的患者相比，接受放疗和手术的子宫外疾病患者的五年相对生存率显著更长。接受类似治疗的女性在生存率方面没有种族差异。
辅助治疗可提高II - IV期疾病女性的生存率。接受类似治疗的黑人和白人患者的生存率相似。
