The influence of patients‐ age and tumor grade on the prognosis of carcinoma of the cervix

• Published in: Cancer Vol. 51; no. 9; pp. 1764 - 1771
• Main Authors: Prempree, Thongbliew, Patanaphan, Vinita, Sewchand, Wilfred, Scott, Ralph M.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.05.1983
• Subjects: Adult; Age Factors; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Female; Humans; Neoplasm Invasiveness; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Retrospective Studies; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - radiotherapy
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19830501)51:9<1764::AID-CNCR2820510934>3.0.CO;2-8

Many factors can influence the prognosis of cancer of the cervix. They range from clinical staging, various histologic cell types, to extensions into the endometrium. Very little is known about the influence of the patients‐ age and constitutional status of the host (patient) on the prognosis of cervical cancer. Over the past several years, we have been observing that when cancer of the cervix occurs in the relatively young patient, they tend to be more aggressive and inspite of the usual accepted treatment, the majority of them do not survive their disease. From 1969 to 1974, 561 patients with proven invasive squamous cell carcinoma of the cervix were treated by irradiation only in the Department of Radiation Therapy, University of Maryland Hospital. Of these, 94 patients were studied and their ages ranged from 23 to 39 years. They were staged following FIGO guidelines and subject to the usual irradiation treatment for cervical cancer. All patients are eligible for a minimum five‐year follow‐up and the absolute five‐year disease‐free survival is as follows: Stage I, 70.2%, (33/47); Stage II, 54%, (14/26); Stage III, 17%, (3/18) and Stage IV, 0%, (0/3). One of the most interesting features observed in Stage I and II disease is distant disease; 26% for Stage I and 42% for Stage II. Further analysis of our result for Stage I and II shows that tumor grading may be responsible for poor outcome. Three Grade systems were used for the study and the result clearly shows that Grade III or poorly differentiated squamous cell carcinoma had the poorest five‐year survival; for example, survival for Stage I disease is 43% and 44% for Stage II. Analysis of the failures following the treatment suggests that about 50% of patients with Grade III disease have already had distant disease by the time the diagnosis was made. Recommendations for futher appropriate treatment is suggested.