Cervical cancer poses a significant global health challenge, with young women being particularly affected. In this study, we aimed to develop and validate prognostic models for young cervical cancer patients. By extracting data from the SEER database and a local hospital database, we conducted a comprehensive analysis.

Unveiling the Prognosis of Young Cervical Cancer Patients with Advanced Models

Age-Stratified Incidence and Outcomes of CC

Our study included 27,658 cases from the SEER database. The restricted cubic spline (RCS) analysis showed a nonlinear relationship between age and cervical cancer-specific mortality. Patients under 36 years old had the lowest risk, while those over 60 had the highest. The Kaplan-Meier curves demonstrated that the young group had the best prognosis, with a 5-year overall survival (OS) and cancer-specific survival (CSS) rate of over 70%.

Baseline Characteristics of Young Group Patients and Differences from the Other Two Groups

Nearly half of the young patients (44.4%) were never married, and a higher proportion had a relatively lower median household income. They showed high treatment compliance, with a higher proportion accepting treatment within 1 month. In terms of clinical characteristics, the young group had a higher proportion of early-stage tumors, smaller tumor sizes, and grade 1 tumors.

Prognostic Factors for Young Cervical Cancer Patients

Using univariate and multivariate Cox regression analyses, we identified pathologic type, FIGO stage, tumor size, and surgery as significant risk factors. Although grade did not meet the p < 0.01 criterion, it was also incorporated due to its recognized importance. Chemotherapy and radiotherapy status were significant high-risk factors but were not included due to potential multicollinearity issues.

Visualization and Validation of the Prognostic Models

Nomograms were developed to visualize the prognostic models. Stage had the greatest impact on prognosis, followed by tumor size. The C-indexes for the OS and CSS prognosis were 0.805 and 0.820, respectively. In the validation cohort from the Guizhou Provincial People's Hospital, the C-index was 0.865, confirming the good predictive ability of the nomograms. The calibration plots also showed a high fit between the nomogram-predicted survival and actual survival.

Comparison of the Nomogram with the FIGO Staging System

The ROC curve comparison showed that our model had higher efficacy in predicting OS than the FIGO staging system (2018). This indicates that our prognostic models, which incorporate additional factors such as pathological type and grade, provide more accurate predictions.

Conclusion

Based on our findings, we defined young cervical cancer as occurring in individuals under 36 years old. The young group had a better prognosis with independent prognostic factors including disease stage, tumor size, grade, histologic type, and surgical intervention. Our prognostic models serve as a valuable supplement to the current FIGO staging system and have good calibration and high accuracy.