xiangqin zheng ^1* suyu li ² Li Suyu ² Xiangqun Fan ^3* lingsi chen ³ yusha chen ³ qiuyuan huang ²

• ¹ Department of Pediatric Surgery, Fujian Maternity and Child Health Hospital, Fuzhou, China
• ² Department of Radiation Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, China
• ³ Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, China

Purpose Lymph node metastasis is an important type of metastasis and an independent risk factor for the prognosis of cervical cancer.The incidence of cervical cancer in China is exhibiting a noticeable shift towards AYAs (adolescents and young adults) which were defined as adolescents and young adults aged 15-39 years .Consequently, we have conducted a comprehensive study to investigate the correlation between the age of cervial cancer patients and the occurrence of pelvic lymph node metastasis (PLNM) .We retrospectively examined the medical records of patients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB1-IIA2 cervical cancer between January 2012 and December 2021. Univariate and multivariate logistic regression analyses, subgroup group analysis, and P-splines smoothing were performed to address the relationship between AYAs and PLNM.Results A total of 448 patients were included in this study, 56 of whom were diagnosed with pelvic lymph node metastasis. Compared to older adults, AYAs diagnosed with FIGO 2009 stage IB1-IIA2 cervical cancer exhibited a notably higher incidence of pelvic lymph node metastasis PLNM (21.5% among AYAs compared to 10.6% among older adults, P< 0.05).We observed a negative correlation between age and PLNM, with a statistically significant difference. Specifically, for each one-year increase in age, there was a 7% reduction in the risk of PLNM (OR, 0.93; 95% confidence interval, 0.89-0.97; P < 0.001). Multivariate analysis revealed that AYAs were associated with a higher incidence of PLNM after adjusting for conventional risk factors (adjusted risk ratio 3.59; 95% confidence interval, 1.598.07, P = 0.002).Subgroup analysis substantiates the consistency Conclusion AYAs with FIGO 2009 stage IB1-IIA2 cervical cancer may have a higher incidence of pelvic lymph node metastasis than older adults. These findings merit further investigation.Keywords Cervical cancer • Lymph node metastasis• Gynecological malignant tumor, Adolescents and young adults, lymphovascular space invasion.