Maternal and Fetal Outcomes in Pregnancies affected by Bone and Soft Tissue Tumors

Abstract

Objective This study was aimed to describe perinatal outcome of a cohort of pregnant patients with bone and soft tissue tumors and to compare the current series with our group's previously reported experience. Methods Pregnant women diagnosed before and during pregnancy were identified, retrospectively, for the years 2004 to 2014. Relevant maternal and neonatal data were collected. Results Forty-eight patients were identified. Ten cases were diagnosed during pregnancy. Pelvis, abdomen, and extremities were the most common tumor locations. Osteosarcoma, liposarcoma, and Ewing's sarcoma were the most common histological types and comprise more than 50% of the cases. Metastases occurred in nine cases. Most of the cases (60%) were treated surgically during pregnancy and delivery occurred at term. Chemotherapy was delayed until after delivery. There were no perinatal or infant deaths. Patients presented with advanced maternal disease in 18% in previous report (1983–2003) versus 40% in present report (2004–2014). Metastases were present in 40% and maternal death rate was approximately 20% in both cohorts. Conclusion Pregnant women with bone and soft tissue tumors are candidates for standard surgical management during pregnancy. Other treatments, such as chemotherapy and radiotherapy must be evaluated for each woman on a case-by-case basis. Iatrogenic prematurity was common in our findings.

Cancer survival in women diagnosed with pregnancy-associated cancer: An overview using nationwide registry data in Sweden 1970–2018

“…We found a non-significantly increased mortality for women with lung cancer diagnosed during pregnancy but not if diagnosed postdelivery. In line with previous reports, we found no increased mortality in women with pregnancy-associated bone/soft-tissue sarcoma [38]. However, in women with gynecological sarcomas diagnosed after delivery we found a worse prognosis, to our knowledge not previously reported [39].…”

Pregnancy outcomes in non-gynecological and non-hematological cancers: a retrospective cohort

“…10 According to Figueiro-Filho et al, preterm birth and fetal growth restriction were common associations. 11 In this study preterm birth was seen but fetal growth restriction was not seen. Chemotherapeutic agents like Vincristine, Adriyamicin and Cyclophosphamide was used for one woman during pregnancy.…”

Maternal deaths among patients with cancer in the United States

“…However, the number of patients included in these studies was relatively small. [17,18] Therefore, the implication of chemotherapy to cancer patients complicated by pregnancy may be underappreciated, and whether chemotherapy would increase the risk of maternal deaths still requires more large-scale and in-depth populationbased researches. The observed number of deaths represents the total number of maternal deaths in patients with cancer recorded during the study period; the expected number represents the number of individuals who have maternal deaths in the general population with a similar distribution of age, race, and origin.…”

“…A Canadian survey of women diagnosed with bone and soft tissue tumors before and during pregnancy and a study on epithelial ovarian cancer indicated that considering the maternal mortality rate, chemotherapy must be evaluated for each woman on a case-by-case basis. However, the number of patients included in these studies was relatively small [17,18] . Therefore, the implication of chemotherapy to cancer patients complicated by pregnancy may be underappreciated, and whether chemotherapy would increase the risk of maternal deaths still requires more large-scale and in-depth population-based researches.…”