Atsuko Sakakibara1, Kunihiko Matsui2, Toshiro Katayama3, Toshihiro Higuchi4, Koichi Terakawa4, Ikuo Konishi5. 1. Department of Preventive Medicine, Medical Research Institute, Kitano Hospital, Osaka, Japan. 2. Department of Community Medicine, Kumamoto University School of Medicine, Kumamoto, Japan. 3. Department of Medical Engineering, Himeji Dokkyo University, Faculty of Health Sciences, Himeji, Japan. 4. Department of Gynecology and Obstetrics, Medical Research Institute, Kitano Hospital, Osaka, Japan. 5. Department of Gynecology and Obstetrics, Graduate School of Medicine and Faculty of Medicine Kyoto University, Kyoto, Japan.
Abstract
AIM: Whether young cervical cancer patients have poorer prognosis compared to older ones has remained controversial over the past half century. The last three decades have seen a rise in morbidity and mortality among young Japanese women with cervical cancer. This reflects the fact that the importance of prevention has not been fully recognized due to limited clinical studies. We examined the relationship between age and prognosis in cervical cancer. METHODS: We retrospectively examined medical records of consecutive patients with International Federation of Gynecology and Obstetrics stage IB and IIB cervical cancer at a hospital in Japan. Patients were divided into two age groups: less than or equal to 39 years (adolescent and young adult [AYA] group) and greater than or equal to 40 years (older adult group). We compared prognosis and clinical factors associated with prognosis between AYA and older adult patients. RESULTS: Data from 182 patients (AYA n = 71; older adults n = 111) treated between 2004 and 2011 were analyzed. The proportion of loss to follow-up was 6.0%. Significant differences were observed in stage and lymph node metastasis between the two groups at baseline. However, despite the older adult group having a higher proportion of advanced cancer patients, the overall survival rate of stage IIB patients in the AYA group at the 3-year follow-up was significantly lower (AYA 53.6%, older adults 86.3%, P < 0.05). Multivariate analysis adjusted for clinical factors revealed that AYA patients had a 3.7-3.9 times greater mortality risk compared to older adults. CONCLUSION: AYA patients with stage IB and IIB cervical cancer may have a prognostic disadvantage.
AIM: Whether young cervical cancerpatients have poorer prognosis compared to older ones has remained controversial over the past half century. The last three decades have seen a rise in morbidity and mortality among young Japanese women with cervical cancer. This reflects the fact that the importance of prevention has not been fully recognized due to limited clinical studies. We examined the relationship between age and prognosis in cervical cancer. METHODS: We retrospectively examined medical records of consecutive patients with International Federation of Gynecology and Obstetrics stage IB and IIB cervical cancer at a hospital in Japan. Patients were divided into two age groups: less than or equal to 39 years (adolescent and young adult [AYA] group) and greater than or equal to 40 years (older adult group). We compared prognosis and clinical factors associated with prognosis between AYA and older adult patients. RESULTS: Data from 182 patients (AYA n = 71; older adults n = 111) treated between 2004 and 2011 were analyzed. The proportion of loss to follow-up was 6.0%. Significant differences were observed in stage and lymph node metastasis between the two groups at baseline. However, despite the older adult group having a higher proportion of advanced cancerpatients, the overall survival rate of stage IIB patients in the AYA group at the 3-year follow-up was significantly lower (AYA 53.6%, older adults 86.3%, P < 0.05). Multivariate analysis adjusted for clinical factors revealed that AYApatients had a 3.7-3.9 times greater mortality risk compared to older adults. CONCLUSION:AYApatients with stage IB and IIB cervical cancer may have a prognostic disadvantage.