Cervical cancer in women under age 40: A cohort study of clinicopathological characteristics and fertility-sparing surgery outcomes

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-02-26 DOI:10.1016/j.gore.2025.101710

Matthew Flint , Francesca Yi , Mona Saleh , Xulei Liu , Stephanie V. Blank , Yuxin Liu

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引用次数: 0

Abstract

Objectives

The clinical management of cervical cancer patients under age 40 presents unique challenges, requiring a balance between complete cancer resection and fertility preservation. This study aimed to report on the clinicopathological characteristics of a cohort of young patients, along with the oncologic and reproductive outcomes of those who underwent fertility-sparing surgery (FSS).

Methods

The pathology database at a single institution was searched for women under age 40 who were diagnosed with invasive cervical cancer between 2015 and 2022. Electronic medical charts were reviewed for demographics, tumor characteristics, clinical management, and surveillance. Statistical analysis was performed using Wilcoxon rank-sum test and chi square test.

Results

A total of 57 patients (median age: 34 years; range: 27–40 years) met the inclusion criteria. Cancer histology included squamous cell carcinoma (70 %), adenocarcinoma (28 %), and adenosquamous carcinoma (2 %). The FIGO stage was I (72 %), II (7 %), III (19 %), and IV (2 %). The sensitivity of cytology was 67 %, with notably low significantly for adenocarcinoma (38 %). HPV vaccination documentation was missing for 44 patients (77 %). Among the 16 patients with stage I cancer who underwent FSS, one experienced cancer recurrence (7 %), and four successfully achieved pregnancy.

Conclusions

Our cohort study of young cervical cancer patients highlights deficiencies in cervical cancer prevention, including limitations in cytology-based screening and inconsistent documentation of HPV vaccination. FSS offers a promising approach, with low cancer recurrence rates and encouraging pregnancy outcomes.

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40岁以下女性宫颈癌：临床病理特征和保留生育能力手术结果的队列研究

目的40岁以下宫颈癌患者的临床治疗面临着独特的挑战，需要在肿瘤完全切除和保留生育能力之间取得平衡。本研究旨在报道一组年轻患者的临床病理特征，以及接受生育保留手术（FSS）的患者的肿瘤和生殖结果。方法检索2015 - 2022年间诊断为浸润性宫颈癌的40岁以下女性病理数据库。电子病历回顾了人口统计学、肿瘤特征、临床管理和监测。统计学分析采用Wilcoxon秩和检验和卡方检验。结果共57例患者，中位年龄34岁；范围：27-40岁)符合纳入标准。肿瘤组织学包括鳞状细胞癌（70%）、腺癌（28%）和腺鳞癌（2%）。菲戈阶段是我(72%)、二(7%)、第三(19%),和第四(2%)。细胞学的敏感性为67%，而腺癌的敏感性较低（38%）。44名患者（77%）缺少HPV疫苗接种文件。在接受FSS治疗的16例I期癌症患者中，1例癌症复发（7%），4例成功怀孕。结论一项针对年轻宫颈癌患者的队列研究突出了宫颈癌预防方面的不足，包括细胞学筛查的局限性和HPV疫苗接种的不一致文献。FSS提供了一种很有前途的方法，具有低癌症复发率和令人鼓舞的妊娠结局。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.