Analysis Of Clinical Course And Prognostic Factors Of Cervical Cancer In Young Women

Objective:To analyse the etiology ,clinical and pathological features,prognostic factors and the quality of life(QOL) of cervical cancer in women under 35 years old.Methods:Section one : The clinical information of 58 patients under 35 years old were retrospectively analysed ,in control with 269 patients from 36 to 81 years old between 1999 and 2007 in this hospital.So as to investigate the etiology,clinical and pathological features in younger patients.Section two: The clinicopathologic records of 115 patients with cervical cancer of stageâ… -â…¡A who underwent radical hysterectomy and pelvic lymphadenectomy were retrospectively analyzed, and the prognostic factors were explored by univariate and multivariate methods. Independent prognostic factors were identified by COX proportional hazards regression model.Section three: The Chinese FACT-CX questionnaire were self-reported by the 63 patients treated by surgery.The influential factors of the quality of life(QOL) were explored by multilple linear regression .Results: (1)Section one: The disease stage was at 0 andâ… in 70.69% of the younger patient( P < 0.05). In younger group,contact bleeding was the main symptom that occurred in 63.79%(37/ 58),and there are 16 cases with lymph vascular involvement( P < 0.05) .The rate of pelvic lymph metastasis was 32.61 %(15/ 46) ( P < 0.05).(2)Section two:The 5 year survival rate of stageâ… -â…¡A was 82.95% .The 5-year survival rate in the younger group and the older group were 70.27% and 89.31% respectively (P=0.0386). COX regression analysis indicated that the depth of tumor infiltration,lymph vascular involvement and the number of the pelvic lymph metastasised were independently prognostic factors. For patients with two risk factor after radical surgery , the survival of patients with adjuvant radiation therapy and chemotherapy or not was 83.33 %, 16.67 %, respectively ( P < 0.05)(3)Section three:There was no significant in QOL score between younger patients and the older patients. The age ,inhabitancy,ovarian transposition and schooling degree were the main influential factors of QOL.Conclusions: Early clinical stage was the main characteristic in young patients with cervical carcinoma. In comparison to the older patients with cervical cancer, though the QOL the same,the prognosis was poor in young patients,maybe it was related to higher percentage of the lymph vascular involvement and pelvic lymph node metastasis. Adjuvant treatment may be helpful for patients with 2 or more risk factors after radical surgery,but not for improveing QOL. We should emphasize sexual education and cervical screening to young women.