Surveillance, Epidemiology, and End Results analysis of 2677 cases of uterine sarcoma 1989–1999
Introduction
Uterine sarcomas are rare tumors of the uterus and in previous reports have been estimated to comprise 4–9% of all invasive uterine cancers [1], [2]. The literature describing the epidemiology of these tumors is sparse; with the most comprehensive reports describing these tumors published in 1986 and 1995. In 1986, Harlow et al. [3] noted an excess incidence of leiomyosarcoma and mixed mesodermal sarcoma for blacks compared with whites; however, little information was available at that time regarding survival, stage distribution, and treatment. The subsequent report by Platz and Benda [4] acknowledged leiomyosarcoma and mixed mullerian tumors/carcinosarcoma as the most common of the sarcomas and noted that blacks with carcinosarcoma were less likely to be diagnosed with localized disease compared to whites. Given the observed difference in incidence between blacks and whites, we analyzed data from the network of population-based cancer registries that make up the SEER program of the National Cancer Institute to determine the demographic characteristics, histological distribution, patterns of treatment, and survival in women with uterine sarcoma.
Section snippets
Methods
The inclusion criteria included women over age 35 with invasive malignancies primary to the uterus, and histologically confirmed as leiomyosarcoma, carcinosarcoma (mixed mullerian or mixed mesodermal sarcoma), high-grade endometrial stromal sarcoma (HGESS), adenosarcoma, and sarcoma not otherwise specified using the National Cancer Institute's population-based Surveillance, Epidemiology and End Results (SEER) program International Classification of Disease (ICD-0-2) and ICD-0-3 coding. Due to
Incidence
During the study period of 1989–1999, uterine sarcomas represented 8% of primary uterine malignancies; 2098 were white, 420 black, and 159 were of other races. Statistical comparison of mean age at the time of diagnosis for whites vs. blacks and whites vs. women of other races revealed that white women were significantly older at the time of diagnosis (64.2) compared to blacks (62.7, P < 0.05) and women of other races (58.5, P < 0.01). The age-adjusted incidence rate of uterine sarcoma in black
Discussion
Our results confirm that blacks continue to be at greater risk than whites for the occurrence of uterine leiomyosarcoma and carcinosarcoma. While our report is agreement with that of Harlow et al., it differs with the 1995 report by Platz and Benda who reported an excess incidence of leiomyosarcoma for blacks, but not for carcinosarcoma. The reasons for the differences in findings may reflect our combining carcinosarcoma and mixed mullerian tumors into one group as these tumors are currently
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