韩国子宫内膜癌发病率与生存率的趋势：一项全国性人群基础队列研究

Trends in the incidence and survival outcomes of endometrial cancer in Korea: a nationwide population-based cohort study

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Journal of Gynecologic Oncology

影响因子:3.7

分区:医学2区 / 妇产科学3区肿瘤学3区

发表日期:2024 May

作者: Seung-Hyuk Shim, Jiwon Lim, Ji Hyun Kim, Yeon Jee Lee, Hyeong In Ha, Myong Cheol Lim, Young-Joo Won

DOI: 10.3802/jgo.2024.35.e32

摘要

本研究旨在根据诊断年份、分期、年龄和组织学类型，评估子宫内膜癌（EC）的发病率和生存率的变化趋势。利用韩国中央癌症登记处收集1999年至2018年间诊断的原发性EC患者资料，并追踪至2019年。根据国际疾病分类第十版（ICD-10）编码，计算不同年龄、分期、组织学类型及诊断年份的年龄标准化发病率（ASRs）、年度变化百分比（APCs）和生存率。结果显示，EC的ASR从1999年的每10万例2.38增加到2018年的7.29，所有组织学类型的APCs分别为子宫内膜样（9.82）、浆液性（15.97）和透明细胞（7.73），均具有统计学意义（p<0.001）。不同组织学类型的5年生存率差异明显（子宫内膜样90.9%、浆液性55.0%、透明细胞68.5%，p<0.001），不同分期的生存率亦有显著差异（局限期93.4%、区域性77.0%、远处转移31.0%，p<0.001），年龄组也存在差异（<50岁93.0%、≥50岁80.6%，p<0.001）。2000年至2018年诊断组的5年生存率（85.9%）优于1999-2008年组（83.3%，p<0.001），此改善趋势仅在子宫内膜样癌中显著（p<0.001）。子宫内膜癌的发病率在所有三种组织学类型中均呈上升趋势。子宫内膜样组织的患者生存率在过去二十年有所改善，但浆液性和透明细胞类型的生存率则保持稳定。针对高风险群体的预防策略及针对高危组织学类型的有效治疗仍需加强。

Abstract

To evaluate trends in the incidence and survival outcomes of endometrial cancer (EC) based on the year of diagnosis, stage, age, and histologic types.Women with primary EC diagnosed between 1999 and 2018, and who were followed up with until 2019, were identified from the Korea Central Cancer Registry using the International Classification of Diseases, 10th revision. The age-standardized rates (ASRs) of incidence, annual percent changes (APCs), and survival were estimated according to age, stage, histology, and year of diagnosis.The ASR for EC increased from 2.38 per 100,000 in 1999 to 7.29 per 100,000 in 2018 across all histologic types (APCs of 9.82, 15.97, and 7.73 for endometrioid, serous, and clear cell, respectively, p<0.001). There were significant differences in the 5-year survival rates based on histology (90.9%, 55.0%, and 68.5% for endometrioid, serous, and clear cell, respectively, p<0.001), stage (93.4%, 77.0%, and 31.0% for localized, regional, and distant, respectively, p<0.001), and age (93.0% for <50 years and 80.6% for ≥50 years, p<0.001). The 5-year survival was significantly better in the group diagnosed between 2000 and 2018 (85.9%) than that in the 1999-2008 group (83.3%) (p<0.001). This trend was only observed for endometrioid cancer (p<0.001).The incidence of EC increased across the all 3 subtypes. Survival of patients with endometrioid histology improved over the past two decades, but remained static for serous or clear cell histology. Healthcare strategies to prevent EC incidence in at-risk populations and apply effective treatments for high-risk histology are needed.