Synchronous colorectal liver metastases in pregnancy and post‐partum

Abstract

The diagnosis of mCRC in pregnancy is challenging and survival is poor. A MDT approach to management is essential. Chemotherapy remains the mainstay of treatment from the second trimester. Rapid confirmation of diagnosis and early chemotherapy, followed by post-partum colorectal and liver resection may improve survival.

Chemotherapy During Pregnancy for Advanced Colon Cancer: A Case Report

“…[30][31][32] In the post partum period, aggressive cancer treatment, including surgery for liver metastases, should be considered. 15 Our patient had an exceptionally good response to chemotherapy, with pathologic complete response of the primary tumour, and conversion to resectable liver metastases. We suggest that all available therapeutic options should be considered to increase the possibility of curative treatment and to prolong survival.…”

“…[10][11][12][13][14][15][16][17][18]22,23 Most of these patients have received 5-FU and oxaliplatin in the second or third trimester with reasonable treatment efficacy and safety. [10][11][12][13][14][15] Overviews of the challenges of chemotherapy during pregnancy provide valuable guidance. 8,19,20 Because the patient's need for treatment contrasts with the child's challenges by being prematurely delivered, interdisciplinary cooperation is necessary, including surgeons, oncologists, and obstetricians.…”

“…For CRC, there are some case reports, [10][11][12][13][14][15][16][17] patient series, 18 and literature reviews 8,19,20 of chemotherapy during pregnancy; most have reported on treatment with 5-fluorouracil (5-FU) and oxaliplatin (FOLFOX). 8,[10][11][12][13][14][15]17,18 Case reports of patients treated with FOLFOX during pregnancy for metastatic colorectal cancer are shown in Table 1. Although CRC during pregnancy is often diagnosed at a more advanced stage, patient survival has been reported to be comparable with that in nonpregnant patients.…”

Colorectal Cancer During Pregnancy–Case Report and Brief Review of The Literature

“…Despite the low incidence rate of 0.07% to 0.1% [1][2][3][4][5], cancer accounts as a leading cause of death in women in childbearing ages [6]. CRC is among the eight most common malignancies in pregnancy [7]. Although its incidence is rare, it is associated with serious consequences for both the mother and even the fetus [8].…”

“…Our patient had experienced an intermittent abdominal pain all over her pregnancy with moderate anemia. Common presentations of CRC including abdominal pain, nausea, vomiting, anemia, and rectal bleeding usually masked by pregnancy and it is truly hard to distinguish these symptoms of what is considered as warning signs of CRC [2,[3][4][5][6][7][8][9][10][11][12][13][14]. This delay would lead to late diagnosis of the disease and subsequently poor prognosis.…”