Introduction/Background Cervical Cancer (CC) is uncommon in very young (<35 years) and in geriatric women (> 65 years), age as a prognostic factor is still controversial. The extremes of life had certain risk factors for being diagnosed with locally advanced cervical cancer (LACC); one of them is that in young women, there is a belief that the disease does not occur; therefore, lack of knowledge of the signs, symptoms and, as an essential factor, a lack of adherence to screening is common. In women older 65 years, the screening has been suspended, explaining how this group of women tend to be diagnosed in advanced stages.
This work aims to compare sociodemographic, clinical, and pathological characteristics, response to treatment, disease-free survival, overall survival, and cancer-specific survival in patients with LACC treated with concurrent chemoradiotherapy, clustered by age.
Methodology It is a retrospective study in patients with LACC treated at the National Cancer Institute of Mexico City from 2005 to 2014. A descriptive, comparative, and survival and cancer specific analysis was conducted.
Results From a total of 2,091 patients with LACC, we found 125 patients (9.7%) younger than 35 years (group 1), 533 (41.35), age between 36–50 years (group 2), 444 (34.4%) between 51–65 years (group 3) and 189 (14.6%) of patients 66 years or older. The general characteristics are found in table 1. More than 50% of women from group 4 were illiterate. The patients from groups 1 and 2 clinical stage IB2 was more common. Pre-treatment haemoglobin was lower in groups 1 and 2 vs. groups 3 and 4, and 58.4% of the patients in group 1 required at least one blood transfusion. Cancer-specific survival was different between groups 1 and 2 vs. 3 and 4, p=0.048 (figure 1). Multivariate analysis showed that clinical-stage, Hazard ratio (HR) 3.62 (CI 95% 1.59–8.20), pre-treatment haemoglobin HR 0.944 ( CI 95% 0.89–0.99), and age HR 1.28( CI 95% 1.02–1.64) are independent prognostic factors in patients with LACC, with lack of significance in disease free survival and overall survival.
Conclusion There are demographic, clinical, and treatment response differences between very young and young patients (under 50 years) compared to older patients (over 50 years). Cancer-specific survival, which attempts to remove the bias of advanced age in mortality, showed that women younger than 50 years had higher cancer-related mortality than those of older ages.
Disclosures The authors reports no conflicts of interest.
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