Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
J Gynecol Oncol. 2018 Mar;29(2):e22. doi: 10.3802/jgo.2018.29.e22. Epub 2018 Jan 5.
Uterine carcinosarcoma (UCS) is a rare type of high-grade endometrial cancer (EC) that has been understudied with population-based statistics due to its rarity. This study examined temporal trends in the proportion of UCS among women with EC.
This is a retrospective observational study examining The Surveillance, Epidemiology, and End Results program between 1973-2013. Primary EC cases were eligible for analysis, and a time-specific proportion of UCS was examined during the study period.
UCS was seen in 11,000 (4.7%) women among 235,849 primary EC cases. Mean age at UCS diagnosis increased from 65.9 to 71.7 years between 1973-1989 and then decreased from 71.7 to 67.0 years between 1989-2013 (both, p<0.001). Proportion of Black women significantly increased during the study period (11.9%-20.0%, p<0.001), whereas the proportion of White women decreased from 86.0% to 60.5% between 1987-2013 (p<0.001). There was a significant increase in the proportion of UCS among primary EC from 1.7% to 5.6% between 1973-2013 (p<0.001). Among type II ECs (n=76,118), the proportion of UCS also increased significantly from 6.0% to 17.5% between 1973-2013 (p<0.001). An increasing proportion of UCS was seen in both young and older women but the magnitude of interval increase was larger in the older age group between 1973-2013 (<60 years, from 1.3% to 3.3%. p<0.001; and ≥60 years, from 2.6% to 7.0%, p<0.001).
Our study demonstrated that the proportion of UCS has significantly increased among EC, accounting for more than 5% in recent years.
子宫癌肉瘤（UCS）是一种罕见的高级别子宫内膜癌（EC）类型，由于其罕见性，基于人群的统计学研究对其研究较少。本研究检查了 UCS 占 EC 女性比例的时间趋势。
这是一项回顾性观察性研究，对 1973 年至 2013 年间的监测、流行病学和最终结果计划进行了检查。原发性 EC 病例符合分析条件，并在研究期间检查了 UCS 的时间特异性比例。
在 235849 例原发性 EC 病例中，有 11000 例（4.7%）患有 UCS。UCS 诊断时的平均年龄从 1973-1989 年的 65.9 岁增加到 1989-2013 年的 71.7 岁（均，p<0.001）。在研究期间，黑人女性的比例显著增加（11.9%-20.0%，p<0.001），而白人女性的比例从 1987-2013 年的 86.0%下降到 60.5%（均，p<0.001）。1973-2013 年间，原发性 EC 中 UCS 的比例从 1.7%显著增加到 5.6%（p<0.001）。在 II 型 EC（n=76118）中，UCS 的比例也从 1973-2013 年的 6.0%显著增加到 17.5%（p<0.001）。1973-2013 年间，无论是年轻女性还是老年女性，UCS 的比例都在增加，但老年女性的间隔增长率更大（<60 岁，从 1.3%增加到 3.3%，p<0.001；≥60 岁，从 2.6%增加到 7.0%，p<0.001）。
我们的研究表明，UCS 在 EC 中的比例显著增加，近年来超过 5%。
