Ovarian cancer in pregnancy: a clinicopathologic analysis of 22 cases and review of the literature

Abstract

The aim of this study was to summarize our experience of ovarian cancer diagnosed during pregnancy, to review the literature concerned, and to discuss the rationale for therapy. Twenty-two patients of ovarian malignancies complicating pregnancy were treated at Peking Union Medical College Hospital between 1985 and 2003. Data on treatment and follow-up were reviewed, and their outcomes were analyzed by survival analysis. The incidence of ovarian carcinoma complicating pregnancy in the series was 0.073/1000 pregnancies. Nine (40.9%) were found with ovarian malignant germ cell tumors, six (27.3%) with low malignant potential tumors, five (22.7%) with invasive epithelial tumors, and two (9.1%) with sex cord stromal tumors. Sixteen (72.7%) of the patients were diagnosed in stage I and had achieved complete remission. Four of the five in advanced stage died. Ascites presenting at diagnosis implies advanced disease and gloomy prognosis. The mean follow-up was 47.8 months. The prognosis was significantly related with stage and histologic type (P < 0.05). Thirteen healthy live babies were recorded in this group, and one premature newborn died of respiratory distress syndrome. The clinical characters and prognosis of ovarian cancers complicating pregnancy are similar to those of nonpregnant, reproductive-age women. Management depends on histology of the tumor, stage of the tumor, and the term of the pregnancy. In most of cases, conservative surgical treatment could be performed with adequate staging and debulking equal to the treatment of nonpregnant women. Chemotherapy is not contraindicated during the second or third trimester, but the choice of couple must be considered.

Paclitaxel and cisplatin chemotherapy for ovarian cancer during pregnancy: case report and review of the literature

“…The prognosis of maternal ovarian cancers is similar to those in non-pregnant women in the reproductive age [20]. Suboptimal therapy and initial advanced stage of disease as a result of delayed diagnosis in some pregnant women are associated with worse outcome.…”

Ovarian cancer complicated by pregnancy: Analysis of 10 cases

“…There are currently no definitive guidelines in the literature regarding the management of maternal ovarian cancer, with the exception of summaries of international consensus meetings (8,9). Subsequently, a number of studies have reported and discussed numerous issues pertaining to this issue (10)(11)(12)(13)(14). We have focused on results-oriented points including the incidence, diagnosis, histopathology, treatment and maternal or neonatal outcomes.…”

A favorable maternal and neonatal outcome following chemotherapy with etoposide, bleomycin, and cisplatin for management of grade 3 immature teratoma of the ovary

“…Immature teratoma is frequent in young women, 1 and usually present with subacute abdominal pains due to rapid growth of a large, unilateral tumor undergoing capsular distention, hemorrhage or necrosis. In more advanced diseases, ascites may develop and cause abdominal distention.…”

“…1 The reported incidence of pregnancy complicated by an immature teratoma is 0.07%. 2 This tumor is highly malignant and may threaten the life of the mother.…”