Clinical And Prognostic Analysis Of Invasive Cervical Carcinoma In Women Aged 40 And Younger

Objective To investigate the clinical and pathological features,prognosis and prognostic factors of invasive cervical carcinoma in women aged 40 and younger.Methods 63 cases of invasive cervical carcinoma less than 40 years old were treated in affiliated cancer hospital of Tianjin medical university from 1980 to 1997,the record were retrospectively analysed,in control with 80 cases over 40 years at the same period.Results The percentage of invasive carcinoma in young women increased from 1.8% to 16.0% in the last two decades.Compared with the control group,the mean first marriage age.pregnancy and delivery numbers were lower,and the percentage of contact bleeding symptom, adenocarcinoma type, low differentiated grade was higher in the study group,the difference was sigm'ficant(p<0.05).The overall survival rate of 5 years in study group was 50.8% compared with 72.5% in control group(p<0.01), but the adenocarcinoma in two groups had similar prognosis, on the contrast,young women cervical squamous carcinoma had poorer outcome, both the overall and stage II a/ II b/IIIsurvival rate were lower than women over 40 years .In the study group,recurrence and metastasis was more frequent (52.4%)than in the control group (32.5%),the mean intervial from diagnosis to recurrence was 9.5 months versus 22.4 months in older group, and 66.7% recurrent in 1 year, recurrence and metastasis rate was strong higher of young women in stage I b and Hl(p<0.01).The risk prognostic factors associated with invasive cervical carcinoma in young women included tumor maximum size(>4cm),endophytic andulcerative tumor, advanced stage and grade,non-squamous carcinoma and pelvic lymph metastasis.Conclusions There is an increasing prevalence of invasive cervical carcinoma in women under 40 years old .The prognosis is poorer than that in older women,the reasons may associated with high proportion of adenocarcinoma, low differentiation grade and high involvement pelvic lymph node.The attention should be paid to young women with high risk factors of invasive cervical carcinoma,individual management and adequate therapy should be considered.