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Observational Study
. 2018 Mar;29(2):e22.
doi: 10.3802/jgo.2018.29.e22. Epub 2018 Jan 5.

Trends of uterine carcinosarcoma in the United States

Koji Matsuo  1   2 , Malcolm S Ross  3 , Hiroko Machida  4 , Erin A Blake  1 , Lynda D Roman  1   5
Affiliations
Observational Study

Trends of uterine carcinosarcoma in the United States

Koji Matsuo et al. J Gynecol Oncol. 2018 Mar.

Abstract

Objective: 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.

Methods: 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.

Results: 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).

Conclusion: Our study demonstrated that the proportion of UCS has significantly increased among EC, accounting for more than 5% in recent years.

Keywords: Carcinosarcoma; Endometrial Neoplasms; Trends.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Trends of age at cancer diagnosis. Y-axis is truncated to 50%–75%. The yellow and blue lines are modeled estimates and the dots represent actual observed values. EC, endometrial cancer; UCS, uterine carcinosarcoma.
Fig. 2
Fig. 2
Trends of UCS (among all histology types). Proportion of UCS per calendar year is shown for all primary EC. The yellow line is modeled estimates and dot with 95% CI are actual observed values. CI, confidence interval; EC, endometrial cancer; UCS, uterine carcinosarcoma.
Fig. 3
Fig. 3
Trends of UCS (among type II histology). Proportion of UCS per calendar year is shown for all primary EC. The yellow line is modeled estimates and dot with 95% CI are actual observed values. CI, confidence interval; EC, endometrial cancer; UCS, uterine carcinosarcoma.
Fig. 4
Fig. 4
Trends of UCS (age stratification). Proportion of UCS per calendar year is shown for age stratification. The yellow and blue lines are modeled estimates and dot with 95% CI are actual observed values. CI, confidence interval; UCS, uterine carcinosarcoma.
Fig. 5
Fig. 5
Trends of race among UCS. Proportion of race per calendar year is shown. The 4 lines are modeled estimates and the dots for actual observed values. UCS, uterine carcinosarcoma.
See this image and copyright information in PMC

Comment in

  • Clinical utility of CA-125 in the management of uterine carcinosarcoma.
    Matsuo K, Ross MS, Yunokawa M, Johnson MS, Machida H, Omatsu K, Klobocista MM, Im DD, Satoh S, Baba T, Ikeda Y, Bush SH, Hasegawa K, Blake EA, Takekuma M, Shida M, Nishimura M, Adachi S, Pejovic T, Takeuchi S, Yokoyama T, Ueda Y, Iwasaki K, Miyake TM, Yanai S, Nagano T, Takano T, Shahzad MM, Ueland FR, Kelley JL, Roman LD. Matsuo K, et al. J Gynecol Oncol. 2018 Nov;29(6):e88. doi: 10.3802/jgo.2018.29.e88. J Gynecol Oncol. 2018. PMID: 30207096 Free PMC article. No abstract available.

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