A Japanese survey of malignant disease in pregnancy

Kobayashi, Yoshiyuki; Tabata, Tsutomu; Omori, Mayu; Kondo, Eiji; Hirata, Toru; Yoshida, Kenta; Sekiguchi, Masayuki; Itakura, Atsuo; Enomoto, Takayuki; Ikeda, Tomoaki

doi:10.1007/s10147-018-1352-x

Cited by 19 publications

(18 citation statements)

References 21 publications

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“…20,21 Cancer treatment during pregnancy should limit iatrogenic prematurity. 7,22 Our results are generally consistent with previous published data from record linkage studies. In a study from Australia between 1994 and 2008 9 women with cancer diagnosed during pregnancy had higher rates of labor induction, caesarean section and planned preterm birth respect healthy women.…”

Section: Neonatal Outcomessupporting

confidence: 92%

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Obstetric and Neonatal Outcomes in Women with Pregnancy Associated Cancer: A Population-based Study in Lombardy, Northern Italy

Esposito

Franchi

Dalmartello

et al. 2020

Preprint

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Background: Pregnancy associated cancer (PAC) may lead to adverse obstetric and neonatal outcomes. This study aims to assess the association between PACs and adverse perinatal outcomes [i.e. labor induction, iatrogenic delivery, preterm birth, small for gestational age (SGA) newborn, low Apgar score, major malformations, perinatal mortality] in Lombardy, Northern Italy. Methods: This population-based historic cohort study used the certificate of delivery assistance and the regional healthcare utilization databases of Lombardy Region to identify beneficiaries of National Health Service who delivered between 2008 and 2017. PACs were defined through oncological ICD-9-CM codes reported in the hospital discharge forms. Each woman with PAC was matched to four women randomly selected from those cancer-free (1:4). Log-binomial regression models were fitted to estimate crude and adjusted prevalence ratio (aPR) and the corresponding 95% confidence interval (CI) of each perinatal outcome among PAC and cancer-free women. Results: Out of the 657,968 deliveries, 831 PACs were identified (1.26 per 1000). PAC diagnosed during pregnancy was positively associated with labor induction or planned delivery (aPR=1.80, 95% CI: 1.57-2.07), cesarean section (aPR=1.78, 95% CI: 1.49-2.11) and premature birth (aPR=6.34, 95% CI: 4.59-8.75). No association with obstetric outcomes was found among PAC diagnosed in the post-pregnancy. No association of PAC, neither during pregnancy nor in post-pregnancy was found for SGA (aPR=0.71, 95% CI: 0.36-1.35 and aPR=1.04, 95% CI: 0.78-1.39, respectively), but newborn among PAC women had a lower birth weight (p-value<0.001). Newborns of women with PAC diagnosed during pregnancy had a higher risk of borderline significance of a low Apgar score (aPR=2.65, 95% CI: 0.96-7.33) as compared to cancer-free women. Conclusion: PAC, especially when diagnosed during pregnancy, is associated with iatrogenic preterm delivery, compromising some neonatal heath indicators.

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Section: Neonatal Outcomessupporting

confidence: 92%

“…Abdominal-pelvic or cervix cancer is a primary indication to cesarean Sect. 3,22 Moreover, the premature births were more common among women with PAC and a high rate of these were iatrogenic or induced deliveries. In our study, women with thyroid cancer did not follow this pattern, giving birth at term in the most cases.…”

Section: Neonatal Outcomesmentioning

confidence: 99%

Obstetric and Neonatal Outcomes in Women with Pregnancy Associated Cancer: A Population-based Study in Lombardy, Northern Italy

Esposito

Franchi

Dalmartello

et al. 2020

Preprint

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“…Cancer in pregnancy is extremely rare, with 0.001–0.09% of pregnancies being affected [1,2]. Rarer still is gastric carcinoma, which has an incidence of 0.2/100 000 pregnancies [2].…”

Section: Introductionmentioning

confidence: 99%

“…Cancer in pregnancy is extremely rare, with 0.001–0.09% of pregnancies being affected [1,2]. Rarer still is gastric carcinoma, which has an incidence of 0.2/100 000 pregnancies [2]. Diagnosis of cancer in pregnancy is difficult and can be delayed due to comparable symptoms such as nausea, abdominal pain, anemia, and fatigue [3].…”

Section: Introductionmentioning

confidence: 99%

Signet Ring Cell Carcinoma with Lymphangitic Carcinomatosis in Pregnancy: A Case Report of an Unexpected Maternal Death and Review of the Literature

et al. 2019

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Patient: Female, 26-year-oldFinal Diagnosis: Adenocarcinoma with signet-ring cell featuresSymptoms: 32 week gestation with new onset chest pain and shortness of breathMedication: —Clinical Procedure: —Specialty: Obstetrics and GynecologyObjective:Rare co-existance of disease or pathologyBackground:Cancer in pregnancy is extremely rare, and gastric cancers are rarer still. Diagnosis is difficult in pregnancy due to overlapping symptoms with pregnancy such as nausea, pain, anemia, and fatigue.Case Report:A 26-year-old G1 woman at 32 weeks gestation with a past medical history of systemic lupus erythematosus presented with new-onset chest pain and shortness of breath. Computed tomography of the chest, electrocardiogram, and echocardiogram were normal. Laboratory evaluation revealed thrombocytopenia, proteinuria of 480 milligrams, and normal complement. She delivered on hospital day 3 due to worsening chest pain. During cesarean delivery, the patient became hypotensive and hypoxic and required intensive care unit admission after a cesarean hysterectomy. On postoperative day 2 she had a pulmonary embolus and was started on therapeutic anticoagulation. She clinically improved until postoperative day 4, when she was found unresponsive with pulseless electrical activity. After 38 minutes of Advanced Cardiac Life Support, death was pronounced. An autopsy was performed and the cause of death found to be complications of multi-organ system involvement of adenocarcinoma with signet ring cell features. Lymphangitic carcinomatosis was noted throughout the lungs.Conclusions:This patient had adenocarcinoma with signet ring cell features and associated lymphangitic carcinomatosis, which led to her postpartum death. Lymphangitic carcinomatosis is associated with an exceedingly poor prognosis, especially in pregnancy.

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“…Recently, malignancy during pregnancy has increased and the most common type of malignancy is uterine cervical cancer 6,7 . Cervical cancer during pregnancy is mostly stage I disease, and the standard care of the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical cancer in pregnancy is radical hysterectomy with fetus in utero or cesarean radical hysterectomy 7 .…”

Section: Introductionmentioning

confidence: 99%

PET/MR Imaging for the Evaluation of Cervical Cancer During Pregnancy

Ishiguro

Nishikawa²,

Ishii

et al. 2020

Preprint

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Background: To assess the diagnostic value of positron emission tomography/magnetic resonance imaging (PET/MRI) for cervical cancer propagation before surgery, especially in pregnant women.Methods: 18F Fluorodeoxyglucose (FDG)-PET/MRI was performed in seven pregnant cervical cancer patients (28 - 34 years old) at 9-18 gestational weeks. In case #5, a second PET/MRI was performed at 24 gestational weeks. Results: Of seven FDG-PET/MRI examination series in six cases (cases #1-#6), FDG-PET/MR imaging could detect cervical tumors with abnormal FDG accumulation; these tumors were confirmed with a standardized uptake value max (SUV max) titer of 4.5 - 16. A second PET/MRI examination in case #5 revealed the same SUV max titer as the first examination. In these six imaging series (cases #1-#5), there were no signs of cancer metastasis to the parametrium and lymph nodes. However, in case #6, abnormal FDG accumulation in the left parametrial lymph nodes was also detectable. Pathological examination showed lymph node metastasis in case #6. In case #7, PET/MRI could not detect any abnormal FDG accumulation in the cervix and other sites. Cone biopsy demonstrated only micro-invasive squamous cell carcinoma. After treatment for cervical cancer, all seven patients have had no recurrence of disease within the follow-up period (2.4 – 5.2 years), and their children have developed appropriately.Conclusion: PET/MRI is an effective and relatively safe imaging tool to evaluate cervical cancer progression in pregnancy.

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A Japanese survey of malignant disease in pregnancy

Cited by 19 publications

References 21 publications

Obstetric and Neonatal Outcomes in Women with Pregnancy Associated Cancer: A Population-based Study in Lombardy, Northern Italy

Obstetric and Neonatal Outcomes in Women with Pregnancy Associated Cancer: A Population-based Study in Lombardy, Northern Italy

Signet Ring Cell Carcinoma with Lymphangitic Carcinomatosis in Pregnancy: A Case Report of an Unexpected Maternal Death and Review of the Literature

PET/MR Imaging for the Evaluation of Cervical Cancer During Pregnancy

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