Uterine sarcomas, insight into its risk factors: A systematic review.

Abstract

e23540 Background: Uterine sarcomas are rare and aggressive malignant tumors that arise from the smooth muscle or connective tissue cells of the uterus. They account for approximately 1% of the female tract malignancies and 3% of all malignant tumors of the uterus. The risk factors that would predispose to uterine sarcomas have always been unknown, with no clear correlation with specific etiologies. This review is to investigate the risk factors that have been looked at by prior studies to have a better understanding of the population at higher risk for uterine sarcomas. Methods: A total of 88 studies were obtained via Pubmed search. The search terms included: Uterus, sarcoma, and risk factors. We also included reviews with the following mesh terms: Uterus, Sarcoma, Etiology and factors. We reviewed studies in English (n = 75) and French (n = 4) languages, human studies and comprising adults. We included only studies with electronic copies. Retrospective, case-control studies and systematic reviews were included. Results: Of the 88 studies, 18 mentioned risk factors and demographic characteristics of the population with uterine sarcomas. Some studies have shown an association with the tumor size – especially more than or equal to 8cm-, uterine weight, patient’s age being > 45-50 years old, age at menarche, obesity, tamoxifen use, previous pelvic irradiation, as well as genetic associations. Mixed evidence has been found regarding the role of the ethnicity, age at menopause, age at first live birth and exogenous estrogen use. Breast cancer has been linked to more aggressive histologic cell types. Conclusions: Given its relatively rare incidence, uterine sarcoma has been mysterious in regards to its risk factors. The results of this review highlight the need for further studies to investigate the risk factors and exposures that may lead to development of uterine sarcomas, as well as linking them to the different histologic types.