Treatment and clinical outcomes of cervical cancer during pregnancy

Ma, Jing; Yu, Lan; Xu, Fan; Yi, Hongyan; Wei, W.; Wu, Peng; Wu, Sha; Li, Hua; Hong, Ye; Wang, Wei; Xing, Hui; Fan, Liangsheng

doi:10.21037/atm.2019.04.76

Cited by 6 publications

(6 citation statements)

References 41 publications

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“…This was taken to indicate that continuation of the pregnancy did not adversely affect maternal oncologic treatment. In contrast, other studies have reported that delayed treatment did aggravate tumor progression, with higher mortality rates and disease recurrences [ 19 , 20 ]. However, in these studies, the clinical features (such as clinical stage, tumor size, lymph node metastasis) were not compared between the continuation of pregnancy group and the termination of pregnancy group.…”

Section: Discussionmentioning

confidence: 86%

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: 86%

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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“…7 Study shows the 5 years disease specific survival for delayed treatment is 61%, whereas for the immediate action is 86%. 10 Administration of NACT can help to control the tumor progression. NACT has been applied in a case of 21 weeks pregnant woman with cervical carcinoma FIGO stage IB1 in China, who wanted to continue the pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Treatment Approach for A Rare Case of Cervical Cancer in Pregnancy

Putri¹,

Wiranegara²

2022

Indones J Obstet Gynecol

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Abstract Objective: To add a new overview of cervical cancer in pregnancy and to review several treatment approaches using available guidelines. Methods: Case report. Case: A 29 years old woman, gravida 3 para 2 in 10 weeks of pregnancy, was presented with vaginal bleeding and bloody vaginal discharge. Ultrasound examination showed a 10 weeks single live intrauterine fetus and a mass on the cervix. The histopathological report revealed a poorly differentiated cervical adenocarcinoma without invasion of lymphovascular space. Patient was diagnosed with cervical carcinoma FIGO stage IB3 in 10 weeks of pregnancy. The patient opted to unpreserved the pregnancy. Radical hysterectomy with fetus in situ and bilateral pelvic lymphadenectomy was performed. Patient was referred to undergo adjuvant radiation therapy. Conclusion: Cervical cancer in pregnancy is a rare and special condition that requires individual planning for the diagnostic and treatment approaches. Keywords: cervical cancer, cervical cancer in pregnancy, fetus in situ hysterectomy, pregnancy, radical hysterectomy. Abstrak Tujuan: Untuk menambah gambaran kasus mengenai kanker serviks dalam kehamilan serta membahas pendekatan terapi menggunakan pedoman – pedoman yang ada. Metode: Laporan kasus. Kasus: Seorang perempuan berusia 29 tahun dengan G3P2 usia kehamilan 10 minggu datang dengan keluhan perdarahan pervaginam dan keputihan bercampur darah. Hasil dari USG menunjukkan adanya janin berusia 10 minggu serta massa pada serviks. Hasil pemeriksaan histopatologi menunjukkan adanya adenokarsinoma serviks berdiferensiasi buruk tanpa invasi limfovaskuler. Pasien didiagnosis dengan kanker serviks stadium FIGO IB3 dalam kehamilan 10 minggu. Pasien setuju untuk dilakukan terminasi kehamilan. Pada pasien kemudian dilakukan laparotomi histerektomi radikal dengan fetus in situ serta limfadenektomi pelvik bilateral. Pasien kemudian dirujuk untuk dilakukan terapi ajuvan dengan radiasi. Kesimpulan: Kanker serviks pada kehamilan merupakan suatu kondisi khusus sehingga perencanaan diagnostik dan manajemen terapi membutuhkan perencanaan secara individual di setiap kasusnya. Kata kunci: Kanker, kanker serviks, kanker serviks dalam kehamilan, kehamilan, , histerektomi radikal, histerektomi dengan fetus in situ.

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“…Obstetrics, neonatology, gynecological oncology, pathology, imaging, and other disciplines need to participate in formulating treatment plans. Strike a balance between effective treatment of tumors and protection of fetal health to avoid delayed treatment and premature delivery ( 10 , 11 ). For details, please refer to the Chinese Expert Consensus on Diagnosis and Treatment of Pregnancy Complicated with Cervical Cancer, formulated by the Chinese Obstetricians and Gynecologists Association (COGA) ( 11 ).…”

Section: Multidisciplinary Diagnosis and Treatment In Ccipmentioning

confidence: 99%

Chinese Expert Consensus on ovarian function and fertility preservation of cervical cancer in pregnancy (2023)

Ruan

2023

Front. Endocrinol.

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Cervical cancer in pregnancy (CCIP) refers to cervical cancer diagnosed during pregnancy, the most common gynecological malignant tumor. Because of the special physiological changes of CCIP, although preserving ovarian function and fertility is very important, the methods are very limited. There is no guideline or consensus on the preservation methods of ovarian function and fertility in this special period. Therefore, the Committee of Fertility Protection and Preservation of China Association for the Promotion of Health Science and Technology, combined with the Chinese Society of Gynecological Endocrinology affiliated to the International Society of Gynecological Endocrinology, Society Endocrinology Branch of Beijing Institute of Obstetrics & Gynecology, combined with Society on Fertility Preservation affiliated with the Chinese Preventive Medicine Association, organized relevant experts from different disciplines to formulate this consensus, in order to guide ovarian function and fertility preservation of CCIP patients.

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Treatment and clinical outcomes of cervical cancer during pregnancy

Cited by 6 publications

References 41 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

Treatment Approach for A Rare Case of Cervical Cancer in Pregnancy

Chinese Expert Consensus on ovarian function and fertility preservation of cervical cancer in pregnancy (2023)

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