| Objective:95% of ovarian malignancies are epithelial ovarian cancer（EOC）.Like most epithelial cancers,EOC is more common in women over the age of 50.Due to differences in the age of susceptibility and biological characteristics of different histological types of ovarian cancer,patients with EOC in different age groups have unique clinical characteristics.EOC patients under the age of 35 are rare in the clinic,but with the development and use of targeted drugs,younger cancer survivors may face longer tumorbearing survival.To grasp the clinical characteristics of these patients and provide earlier and more accurate diagnosis and treatment is of great significance for improving the survival and quality of life of young EOC patients.Methods:A total of 58 young patients with epithelial ovarian cancer（≤ 35 years old at the time of diagnosis）who were treated in the Provincial Hospital of Anhui Medical University from January 2005 to December 2020 were collected.General characteristics such as age,height,weight,reproductive history,and surgical methods,pathology,and symptoms were extracted from our database,and the data were analyzed using SPSS software.In addition,353 cases of young epithelial ovarian cancer from the SEER（Surveillance,Epidemiology and End Results）database were screened and analyzed.Results:（1）A total of 58 young ovarian cancer patients（age ≤35 years old at diagnosis）were included in this study.The mean age at diagnosis was 30.62±4.38 years old.39 cases（67.24%）were in FIGO stage I/II,and 19 cases（32.76%）were in stage III/IV.The most common histology subtype was high-grade serous ovarian cancer（25.86%）,and the least was endometrioid cancer（10.34%）.（2）5 patients received fertility-sparing surgery,with an average age of 24.88 years old,another 11 cases of mucinous or low-grade serous ovarian cancer at stage IA or IC were selected for standard staging,and there were significant differences in the average BMI and marital status between the two groups.（3）Patients with mucinous carcinoma were younger than those other subtypes（28.33 vs31.22,P=0.041）.（4）26 out of 58 patients（44.83%）had no symptoms before the first visit,and the most common initial symptom was chronic abdominal distension and abdominal pain（16 cases）.6 patients were pregnant,puerperium,or after assisted reproductive procedures when diagnosed.（5）Among the 353 epithelial ovarian cancer patients aged 15-34 years old in the SEER database,5.38% and 13.31% were in the 15-19 and 20-24 groups,respectively,and nearly 80% of the patients were over 25 years old;36.83% of all are mucinous carcinoma,followed by serous carcinoma（32.01%）;according to AJCC staging,70% were stage I/II,and 30% were stage III/IV.（6）The mean overall survival of 343 patients was 138.3±3.1 months,the five-year survival rate was84.4%,and the ten-year survival rate was 78.3%.In multivariate analysis,the risk of death in stage III/IV patients was more than six times higher than that in early-stage patients（RR=6.436,P<0.001）.The early and advanced stage were analyzed separately,and it was found that in patients with stage III-IV,the prognosis of mucinous carcinoma was significantly worse（RR=3.164,P=0.002）.The five-year survival rates for mucinous carcinoma and mucinous carcinoma were 67.0% and 27.95%,respectively.However,whether or not fertility-sparing surgery was performed does not affect prognosis.Conclusion:（1）This study showed that young patients with epithelial ovarian cancer under the age of35 have unique clinicopathological features: HGSOC and mucinous carcinoma is the most common,most of them are early stage,and the prognosis is good.（2）Fertility needs are the most important factor in deciding on fertility-sparing surgery.（3）In young patients with advanced stage（FIGO III/IV）,the prognosis of mucinous carcinoma is much worse than that of non-mucinous carcinoma,with a five-year survival rate of only 27.95%. |
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