ABSTRACT
No abstract available.
Subject(s)
Lymph Nodes , Neoplasm Metastasis , Uterine Cervical NeoplasmsABSTRACT
OBJECTIVE: To examine the association between tumor grade and survival for women with squamous cervical cancer. METHODS: This retrospective observational study utilized the Surveillance, Epidemiology, and End Result program data between 1983 and 2013 to examine women with squamous cervical cancer with known tumor differentiation grade. Multivariable analyses were performed to assess independent associations between tumor differentiation grade and survival. RESULTS: A total of 31,536 women were identified including 15,175 (48.1%) with grade 3 tumors, 14,084 (44.7%) with grade 2 neoplasms and 2,277 (7.2%) with grade 1 tumors. Higher tumor grade was significantly associated with older age, higher stage disease, larger tumor size, and lymph node metastasis (all, p < 0.001). In a multivariable analysis, grade 2 tumors (adjusted-hazard ratio [HR]=1.21; p < 0.001) and grade 3 tumors (adjusted-HR=1.45; p < 0.001) were independently associated with decreased cause-specific survival (CSS) compared to grade 1 tumors. Among the 7,429 women with stage II–III disease who received radiotherapy without surgical treatment, grade 3 tumors were independently associated with decreased CSS compared to grade 2 tumors (adjusted-HR=1.16; p < 0.001). Among 4,045 women with node-negative stage I disease and tumor size ≤4 cm who underwent surgical treatment without radiotherapy, grade 2 tumors (adjusted-HR=2.54; p=0.028) and grade 3 tumors (adjusted-HR=4.48; p < 0.001) were independently associated with decreased CSS compared to grade 1 tumors. CONCLUSION: Our study suggests that tumor differentiation grade may be a prognostic factor in women with squamous cervical cancer, particularly in early-stage disease. Higher tumor grade was associated with poorer survival.
Subject(s)
Female , Humans , Carcinoma, Squamous Cell , Cervix Uteri , Epidemiology , Epithelial Cells , Lymph Nodes , Neoplasm Metastasis , Observational Study , Radiotherapy , Retrospective Studies , Uterine Cervical NeoplasmsABSTRACT
OBJECTIVE: To examine survival of teenage women with pregnancies complicated by primary ovarian cancer. METHODS: This is a secondary analysis of a previously organized systematic literature review of primary ovarian cancer diagnosed during pregnancy. Cases eligible for analysis were patients whose age at cancer diagnosis and survival outcome were known (n=201). Pregnancy and oncologic outcome were then examined based on patient age. RESULTS: These were comprised of 95 (47.3%) epithelial ovarian cancers (EOCs), 82 (40.8%) malignant germ cell tumors (MGCTs), and 24 (11.9%) sex-cord stromal tumors (SCSTs). Teenage pregnancy was seen in 21 (10%) cases, and was highest among the SCST group compared to the other cancer types (EOC, 1.1%; MGCT, 14.6%; and SCST, 29.2%, p 0.05); however, teenage pregnancy was significantly associated with an increased risk of serious maternal/neonatal adverse events (50% vs. 22.7%, p = 0.013). On univariable analysis, teenage pregnancy was significantly associated with decreased ovarian cancer-specific survival (5-year rate: age ≥ 30, 79.6%; age 20–29, 87.2%; and age < 20, 41.6%; p < 0.001). On multivariable analysis controlling for calendar year, cancer type, cancer stage, and gestational age at ovarian cancer diagnosis, teenage pregnancy remained an independent prognostic factor for decreased ovarian cancer-specific survival compared to women aged ≥ 30 (adjusted-hazard ratio=4.71; 95% confidence interval=1.17–18.9; p = 0.029). CONCLUSION: Teenage women with pregnancies complicated by primary ovarian cancer may be at increased risk of poor survival from ovarian cancer.
Subject(s)
Female , Humans , Pregnancy , Cesarean Section , Diagnosis , Gestational Age , Live Birth , Neoplasms, Germ Cell and Embryonal , Ovarian Neoplasms , Pregnancy in AdolescenceABSTRACT
OBJECTIVE: To examine trends and characteristics of single women with malignancy of the uterine cervix. METHODS: This is a retrospective observational study examining the United States population-based tumor registry (the Surveillance, Epidemiology, and End Results program). Time-specific trends in single marital status were examined in 3,294,208 women among 12 common female malignancies including 87,151 women with uterine cervical malignancy between 1973 and 2013. RESULTS: While the proportion of single women in the majority of malignancies increased during the study time, the proportion of single women with cervical malignancy significantly increased more than in other malignancies (29.3% in 2013 from 6.3% in 1973). There was a surge in the proportion of single women with cervical malignancy starting in the early 1990s, exhibiting the largest annual percentage rate change (APC) among all examined malignancies (1.8%; 95% confidence interval [CI]=1.6, 2.0; p < 0.001). There was a significant decrease in the proportion of women aged < 40 years with cervical malignancy between 1989 and 2013 (APC, −1.2%; 95% CI=−1.4, −1.0; p < 0.001). However, when stratified by age, the proportion of single women aged ≥40 years increased significantly during the time (APC, 2.7%; 95% CI=2.3, 3.2; p < 0.001) but did not in those who were < 40 years (APC, 0.1%; 95% CI=−0.7, 0.6; p=0.850). CONCLUSION: The proportion of single women with malignancy of the uterine cervix has significantly increased in the past 4 decades. This increase was most dramatic in single women aged ≥40 years. Improving screening strategies in single women aged ≥40 years may help reduce the incidence of this malignancy.