子宫乳头状浆液性或透明细胞子宫内膜癌患者的后续恶性肿瘤风险。

The risk of subsequent malignancies in women with uterine papillary serous or clear cell endometrial cancers.

机构信息

Division of Gynecologic Oncology, Magee-Women's Hospital of UPMC, 300 Halket St., Pittsburgh, PA 15213, USA.

出版信息

Int J Gynecol Cancer. 2013 Jul;23(6):1044-9. doi: 10.1097/IGC.0b013e3182959053.

DOI:10.1097/IGC.0b013e3182959053

PMID:23748174

Abstract

OBJECTIVE

Type II endometrial cancers include uterine papillary serous carcinoma (UPSC) and clear cell endometrial cancer (CC). Given their relative rarity, aggressive nature, and poor prognosis, little is known about the risk of subsequent malignancies at other sites. Our objective was to determine if women with UPSC or CC are at increased risk of subsequent malignancies.Type II endometrial cancers include uterine papillary serous carcinoma (UPSC) and clear cell endometrial cancer (CC). Given their relative rarity, aggressive nature, and poor prognosis, little is known about the risk of subsequent malignancies at other sites. Our objective was to determine if women with UPSC or CC are at increased risk of subsequent malignancies.

METHODS

Women diagnosed with UPSC or CC were identified from the SEER (Surveillance Epidemiology and End Results) Program from 1973 to 2005. Cases with a second gynecologic malignancy were excluded. Using SEER*Stat software, standardized incidence ratios (SIRs) of subsequent malignancies were calculated.

RESULTS

A total of 8045 and 1740 patients were diagnosed with UPSC and CC, respectively. Four hundred sixty-one (5.7%) of the UPSC cases were diagnosed with at least 1 additional nongynecologic malignancy. Significant associations were found with the following malignancies: the renal pelvis, soft-tissue sarcomas, acute myeloid leukemia, the bladder, and colon. Seventy-eight CC cases (4.5%) were diagnosed with at least 1 additional malignancy. In comparison with the baseline population risk, there was no statistically significant increased risk of any subsequent malignancy with a primary diagnosis of CC.

CONCLUSIONS

This is the first large population-based analysis of second primary malignancies after type II endometrial cancers. Uterine papillary serous carcinoma is associated with increased risks of certain subsequent malignancies, and providers should be aware of these when following up patients with this diagnosis, especially those with stage I disease. In contrast, no such associations were found with CC in this cohort.

摘要

目的

II 型子宫内膜癌包括子宫乳头状浆液性癌（UPSC）和透明细胞子宫内膜癌（CC）。由于它们相对罕见、侵袭性强且预后不良，因此对于其他部位继发恶性肿瘤的风险知之甚少。我们的目的是确定患有 UPSC 或 CC 的女性是否有更高的继发恶性肿瘤风险。

方法

从 1973 年到 2005 年，我们从 SEER（监测、流行病学和最终结果）计划中确定了诊断为 UPSC 或 CC 的女性。排除了患有第二种妇科恶性肿瘤的病例。使用 SEER*Stat 软件，计算了继发恶性肿瘤的标准化发病比（SIR）。

结果

共有 8045 例 UPSC 和 1740 例 CC 患者被诊断。461 例（5.7%）UPSC 病例被诊断出至少患有另一种非妇科恶性肿瘤。与以下恶性肿瘤有显著关联：肾盂、软组织肉瘤、急性髓系白血病、膀胱和结肠。78 例 CC 病例（4.5%）被诊断出至少患有另一种恶性肿瘤。与基线人群风险相比，原发性 CC 诊断后任何继发恶性肿瘤的风险均无统计学显著增加。