Age as a pre-operative predictor of uterine, bladder, and intestinal invasion in cervical cancer

BackgroundAccurate staging of cervical cancer is essential for treatment planning, with Magnetic Resonance Imaging (MRI) being the modality of choice. Cervical cancer is suspected to have variations in its presentation and etiology depending on the age of patients.PurposeTo explore the association between patient age and specific findings on contrast-enhanced MRI in women with newly diagnosed cervical cancer.Material and MethodsThis study included 146 consecutive patients with pathologically confirmed cervical cancer who underwent 3.0T contrast-enhanced MRI for initial staging. MRI scans were evaluated for tumor size, parametrium, uterine, bladder, and intestinal invasion, among other features. Ordinal, binary, and multinomial logistic regression models were used to assess age as a predictor for MRI stage and specific invasive findings. Receiver Operating Characteristic (ROC) curve analysis was performed for significant findings.ResultsThe mean patient age was 49.1 ± 12.2 years. Age was a significant predictor of a higher MRI stage (OR: 1.029, p = 0.025). Increasing age emerged as a significant predictor for uterine invasion (OR: 1.050, 95% CI: 1.022-1.085, p = 0.002), an association that remained significant even after controlling for disease stage. Age predicted higher odds of bladder mucosal (OR: 1.052, p = 0.011) and non-mucosal intestinal invasion (OR: 1.038, p = 0.041). ROC identified an age cutoff of 45.5 for uterine invasion (AUC: 65.2%).ConclusionRadiologists should maintain a heightened index of suspicion for more extensive local invasion when interpreting cervical cancer staging MRIs in older women.