Trends in endometrial carcinoma: experience of a single institute for four decades

Abstract

Abstract Objective To determine the current prognosis of endometrial carcinoma in Japan by analyzing long-term trends in endometrial carcinoma at our hospital. Methods We divided 1463 patients with endometrial carcinoma who visited our hospital between 1984 and 2022 into group 1984–1991, group 1992–1999, group 2000–2006, group 2007–2014 and group 2015–2022. Trends were determined using the Jonckheere–Terpstra and Cochran–Armitage tests. Data were analyzed using Cox regression analysis. Results When group 2015–2022 was used as a reference in the univariate analysis, the hazard ratios for the other groups were <1. In particular, the hazard ratio for group 2007–2014 was 0.65 (95% confidence interval, 0.47–0.90, P = 0.009), suggesting that the prognosis of group 2015–2022 was worse than that of group 2007–2014 and seemed to be the worst among all prognoses. In multivariate analysis, the hazard ratios for each group were 1.38, 1.42, 1.88, 1.16 and 1, respectively; the group with the worst prognosis changed from group 2015–2022 to group 2000–2006 (hazard ratio, 1.88; 95% confidence interval, 1.27–2.78, P = 0.001). Age and the rate of non-endometrioid carcinoma exhibited significantly increasing trends (P < 0.001 and P < 0.001, respectively), as did the rates of serous and mixed carcinomas (P = 0.001 and 0.024, respectively). The rates of non-endometrioid carcinoma, serous carcinoma and mixed carcinoma were 19.0%, 5.5% and 3.1% in group 2007–2014 and 28.2%, 10.8% and 4.6% in group 2015–2022, respectively. Conclusions The increasing rates of non-endometrioid carcinoma—especially serous and mixed carcinoma—may be associated with the worsening prognosis of endometrial carcinoma at our institution. Careful monitoring is needed to confirm whether this phenomenon is observed throughout Japan.