Individual management of cervical cancer in pregnancy

Abstract

PurposeThe management of cervical cancer in pregnancy persists to be challenging. Therefore, identification of factors that influence the choice of therapeutic management is pivotal for an adequate patient counseling.MethodsWe present a literature review of 26 studies reporting 121 pregnancies affected by cervical cancer. Additionally, we add a retrospective case series of five patients with pregnancy-associated cervical cancer diagnosed and treated in our clinic between 2006 and 2013.ResultsThe literature review revealed that the therapeutic management during pregnancy varies according to the gestational age at diagnosis, while in the postpartum period no influence on the treatment choice could be detected. Also in our case series the choice of oncologic therapy was influenced by the gestational age, the wish to continue the pregnancy and the risks of delaying definitive treatment.ConclusionsThere are no standardized procedures concerning the treatment of cervical cancer in pregnancy. Therefore, in consultation with the patient and a multidisciplinary team, an adequate individualized treatment plan should be determined.Electronic supplementary materialThe online version of this article (doi:10.1007/s00404-015-3980-y) contains supplementary material, which is available to authorized users.

Ovarian dysgerminoma in pregnancy: A case report and literature review

“…34 There are more case reports showed that no abnormalities was observed in infant after the administration of cisplatin in women with cervical cancer. [45][46][47][48] Cisplatin therapy seems the most reliable form of chemotherapy, permitting a good outcome for most patients. It is reported that paclitaxel and carboplatin were used in pregnancy after organogenesis without apparent fetal effects, though the evidence was mainly based on case reports.…”

Cancer in pregnancy: disentangling treatment modalities

“… 5–7 Cervical cancer appears in 0.8–1.5 per 10 000 births, with worse survival outcomes when diagnosed post partum. 5 8 Of note, up to 5% of cervical intraepithelial neoplasia I-II may progress to invasive cancer during gestation. 8 Finally, acute leukaemia and lymphomas are present in 1:75 000–1:100 000 and 1:1000–1:6000 pregnancies, respectively.…”

“… 5 8 Of note, up to 5% of cervical intraepithelial neoplasia I-II may progress to invasive cancer during gestation. 8 Finally, acute leukaemia and lymphomas are present in 1:75 000–1:100 000 and 1:1000–1:6000 pregnancies, respectively. 5 9 Hodgkin's lymphoma is the more frequent hematological malignancy occurring during pregnancy; approximately 3% of Hodgkin's lymphomas are pregnancy associated.…”

Aspirin and Cervical Cancer

“…Cervical cancer, comprising both squamous and glandular differentiation, is not only the fourth most frequent malignancy but also the fourth leading cause of cancer-related death in women worldwide [2]. Inflammation as a cofactor in human papillomavirus (HPV) and cervical carcinogenesis is an active area of research.…”