Abstract 33P
Background
Cervical cancer (CC) is one of leading causes of cancer-related deaths among women, particularly in low-income countries. The age at diagnosis has been associated with contradictory outcomes in different CC cohorts worldwide. We evaluated the impact of age at diagnosis in overall survival (OS).
Methods
Retrospective analysis of CC patients between 2008 and 2012. Patients were divided in two groups: ≤ 40 yo (from 36 to 40) and > 40 yo. Clinical-pathological data was retrieved from clinical files. T test and Mann-Whitney test were performed to evaluate differences between both groups. Kaplan-Meier survival curves and log-rank tests were used to compare OS. Cox proportional hazards regression models were used to identify independent variables with significant influence on the OS.
Results
A total of 448 CC patients were included. 54% were ≤ 40 yo. Significant differences were observed between ≤40yo and older >40yo as follows: age at first pregnancy (18 vs 18.5yo, p=0.016), absence of symptoms (4.1% vs. 0.5%, p=0.038), creatinine levels ≥65 umol/L (26.4% vs. 39.1%, p=0.004), tumor size ≥ 4 cm (84.4% vs. 75.7%, p=0.0027), vaginal involvement (52.3% vs. 41.4%, p=0.034), and FIGO stage I (15.8% vs. 6.9%, p=0.023). With a median follow up of 5yo, the median OS was 172 months and not reached in patients ≤ 40 yo and > 40 yo, respectively. 5-yo OS rate was lower in patients ≤ 40 yo compared with > 40 yo (63.4% vs. 79.3%, p=0.0019). No significant association was detected between OS and the presence of symptoms, Hb levels, parametrial involvement, vaginal involvement, hydronephrosis, and primary treatment. In the multivariate analysis, age > 40 yo shows a significant lower risk of death (HR: 0.37, 0.22-0.62, p=0.0001), while FIGO stage III (HR: 9.36, 2.72-32.34, p=0.0004) and stage IV (HR: 16.44, 3.97-68.10, p=0.0001) showed higher risk of death.
Conclusions
Although patients younger than 40 years old often present with earlier disease, they demonstrate statistically and clinically inferior survival outcomes. Staging and younger age at diagnosis are independently associated with a higher risk of death. The prognostic significance of these findings warrants validation in prospective series, as it suggests that this population may require intensified treatment strategies.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.