Early Invasive Cervical Cancer During Pregnancy

Ferriaoli, Domenico; Buénerd, Annie; Marchiolè, Pierangelo; Constantini, Sergio; Venturini, Pier Luigi; Mathevet, Patrice

doi:10.1097/igc.0b013e31824ff142

Cited by 23 publications

(8 citation statements)

References 33 publications

(45 reference statements)

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“…Further studies have confirmed the safety of less radical surgery in non-pregnant women [ 22 , 23 ]. However, reports have concluded that 1 of 7 (14.3%) cases treated with vaginal radical trachelectomy during pregnancy have resulted in early abortions [ 24 , 25 ]. Ideally, future prospective studies should be carried to validate these findings.…”

Section: Discussionmentioning

confidence: 99%

The effect of preserving pregnancy in cervical cancer diagnosed during pregnancy: a retrospective study

Xie

et al. 2022

BMC Women's Health

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Objective Cervical cancer diagnosed during pregnancy is a rare event, and data regarding efficacy of cancer treatment during pregnancy is limited. This study aimed to assess the safety of continuation of the pregnancy for mother and fetus when concomitantly diagnosed with cervical cancer. Methods This study retrospectively analyzed all cervical cancer patients diagnosed while pregnant or immediately postpartum, inclusive from Jan 2010 to June 2019 at our institute. Patient clinical details and follow-up were obtained from hospital records. Results The study comprised 40 patients with clinical cancer stages of IA1 (1/40, 2.5%); IB1 (15/40, 37.5%); IB2 (10/40, 25%); IIA (12/40, 30%); and IIB (2/40, 5%). There were 38 patients diagnosed during pregnancy, and 2 diagnosed in the postpartum period. Of the 38 patients, 17 were diagnosed in the first trimester, 13 in the second trimester, and 8 in the third trimester. 10 of 38 patients (26.3%) continued their pregnancy after learning of their diagnosis; 7 (70%) in the third trimester and 3 (30%) in the second trimester. The mean time from diagnosis to surgery in the patients who continued their pregnancy was 52.7 days, which was statistically significantly greater than the termination of pregnancy group (52.7 vs. 16.3 days, P < 0.01). Notably, there was no survival difference between the 2 groups (100% vs. 90.91%, P = 0.54), and none of the pregnant women who ultimately died had delayed treatment due to pregnancy. Similarly, the surgical estimated blood loss and operative duration comparison in the 2 groups were not significantly different. Conclusions In the present study, the gestational age of pregnancy at the time of initial diagnosis of cervical cancer was an important determinant in the disease management. Continuation of the pregnancy when diagnosed with cervical cancer may not affect the oncologic outcome of the mother nor increase either surgical or obstetric complications. Additionally, the use of neoadjuvant chemotherapy did not threaten the health of the fetus. These results may be useful in counseling patients facing the diagnosis of cervical cancer during pregnancy.

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Section: Discussionmentioning

confidence: 99%

The effect of preserving pregnancy in cervical cancer diagnosed during pregnancy: a retrospective study

Xie

et al. 2022

BMC Women's Health

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“…Further studies have con rmed the safety of less radical surgery in non-pregnant women [22,23] . However, reports have concluded that 1 of 7 (14.3%) cases treated with vaginal radical trachelectomy during pregnancy have resulted in early abortions [24,25] . Ideally, future prospective studies should be carried to validate these ndings.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Preserving Pregnancy in Cervical Cancer Diagnosed During Pregnancy: A Retrospective Study

Xie

et al. 2021

Preprint

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ObjectiveCervical cancer diagnosed during pregnancy is a rare event, and data regarding efficacy of cancer treatment during pregnancy is limited. This study aimed to assess the safety of continuation of the pregnancy for mother and fetus when concomitantly diagnosed with cervical cancer.MethodsThis study retrospectively analyzed all cervical cancer patients diagnosed while pregnant or immediately postpartum, inclusive from Jan 2010 to June 2019 at our institute. Patient clinical details and follow-up were obtained from hospital records. ResultsThe study comprised 40 patients with clinical cancer stages of ⅠA1 (1/40, 2.5%); ⅠB1 (15/40, 37.5%); IB2 (10/40, 25%); ⅡA (12/40, 30%); and ⅡB (2/40, 5%). There were 38 patients diagnosed during pregnancy, and 2 diagnosed in the postpartum period. Of the 38 patients, 17 were diagnosed in the first trimester, 13 in the second trimester, and 8 in the third trimester. Ten of 38 patients (26.3%) continued their pregnancy after learning of their diagnosis; 7 (70%) in the third trimester and 3 (30%) in the second trimester. The mean time from diagnosis to surgery in the patients who continued their pregnancy was 52.7 days, which was statistically significantly greater than the termination of pregnancy group (52.7 vs 16.3 days, P < 0.01). Notably, there was no survival difference between the 2 groups (100% vs 90.91%, P =0.54), and none of the pregnant women who ultimately died had delayed treatment due to pregnancy. Similarly, the surgical estimated blood loss and operative duration comparing the 2 groups were not significantly different. ConclusionsIn the present study, the gestational age of pregnancy at the time of initial diagnosis of cervical cancer was an important determinant in the disease management. Continuation of the pregnancy when diagnosed with cervical cancer did not affect the oncologic outcome of the mother nor increase either surgical or obstetric complications. Additionally, the use of neoadjuvant chemotherapy did not threaten the health of the fetus. These results may be useful in counseling patients facing the diagnosis of cervical cancer during pregnancy.

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“…That is why decisions have to be taken by a multidisciplinary team of obstetricians, neonatologists, gynaecologists oncologists, medical oncologists, and pathologists not only in such cases but also in the rest of fertility treatment preservations cases similar to our case. One should always take into account what the patient wants and keeping her opinion central to taking decisions [ 11 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pregnancy does not appear to accelerate the natural history of the tumour or increase the incidence of metastatic disease, although thanks to early diagnosis, the survival rate of patients diagnosed during pregnancy seems somewhat higher than in women who are not pregnant. On the contrary or when there is a late diagnosis, there does seem to be a worse prognosis, partly because of therapeutic limits in these specific cases [ 10 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Simple trachelectomy during pregnancy for cervical cancer

Moreno-Luna

Alonso

Santiago

2016

ecancer

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Invasive cervical cancer is rare during a pregnancy, even though it is one of the most frequently diagnosed neoplasias during that time. It is noted that around 30% of women diagnosed with cervical cancer are of reproductive age. This means that up to 3% of cases of cervical cancer are found in pregnant women or those who are in the post-birth period. A cervicovaginal Pap smear is performed as part of the regular checkup for a pregnant woman during the first visit so that cervical cancer can easily be diagnosed early in these women, detecting it early in up to 70–80% of cases. We present here the case of a patient with initial diagnosis of cervical cancer made around 20th week of pregnancy. It was then treated by a simple trachelectomy and cerclage during week 24. The pregnant woman gave birth to a healthy baby at the end of her pregnancy. Definitive treatment was completed three months after giving birth with a total hysterectomy and laparoscopic bilateral salpingectomy while preserving both ovaries. After 17 months of monitoring the patient showed no signs of reoccurrence. In conclusion, during the early stage of cervical cancer conservative management may be a reasonable option to preserve the current pregnancy.

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Early Invasive Cervical Cancer During Pregnancy

Abstract: Diagnosis of cervical cancer can occur during pregnancy. Different options of fertility-sparing treatment can be discussed on the basis of several factors: tumor stage, gestational age, and the patient's desire regarding fertility and pregnancy sparing.

Cited by 23 publications

References 33 publications

The effect of preserving pregnancy in cervical cancer diagnosed during pregnancy: a retrospective study

The effect of preserving pregnancy in cervical cancer diagnosed during pregnancy: a retrospective study

The Effect of Preserving Pregnancy in Cervical Cancer Diagnosed During Pregnancy: A Retrospective Study

Simple trachelectomy during pregnancy for cervical cancer

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