Treatment and prognosis of cervical cancer associated with pregnancy: analysis of 20 cases from a Chinese tumor institution

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• 作者：Xiang Zhang ; Yong-liang Gao ; Yue Yang
• 关键词：Cervical cancer ; Pregnancy ; Treatment ; Prognosis ; 瀹鐧?/li> 濡婂 ; 娌荤枟 ; 棰勫悗
• 刊名：Journal of Zhejiang University SCIENCE B
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：16
• 期：5
• 页码：388-394
• 全文大小：469 KB
• 参考文献：Alouini, S., Rida, K., Mathevet, P., 2008. Cervical cancer complicating pregnancy: implications of laparoscopic lymphadenectomy. Gynecol. Oncol., 108(3):472鈥?77. [doi:10.鈥?016/鈥媕.鈥媦gyno.鈥?007.鈥?2.鈥?06 ]View Article PubMed
  Amant, F., van Calsteren, K., Halaska, M.J., et al., 2009. Gynecologic cancers in pregnancy: guidelines of an international consensus meeting. Int. J. Gynecol. Cancer, 19(Suppl. 1):S1鈥揝12. [doi:10.鈥?111/鈥婭GC.鈥?b013e3181a1d0ec鈥?/span> ]View Article PubMed
  Benhaim, Y., Pautier, P., Bensaid, C., et al., 2008. Neoadjuvant chemotherapy for advanced stage cervical cancer in a pregnant patient: report of one case with rapid tumor progression. Eur. J. Obstet. Gynecol. Reprod. Biol., 136(2):267鈥?68. [doi:10.鈥?016/鈥媕.鈥媏jogrb.鈥?006.鈥?0.鈥?27 ]View Article PubMed
  Boyd, A., Cowie, V., Gourley, C., 2009. The use of cisplatin to treat advanced-stage cervical cancer during pregnancy allows fetal development and prevents cancer progression: report of a case and review of the literature. Int. J. Gynecol. Cancer, 19(2):273鈥?76. [doi:10.鈥?111/鈥婭GC.鈥?b013e31819bcff8鈥?/span> ]View Article PubMed
  Caluwaerts, S., van Calsteren, K., Mertens, L., et al., 2006. Neoadjuvant chemotherapy followed by radical hysterectomy for invasive cervical cancer diagnosed during pregnancy: report of a case and review of the literature. Int. J. Gynecol. Cancer, 16(2):905鈥?08. [doi:10.鈥?111/鈥媕.鈥?525-1438.鈥?006.鈥?0223.鈥媥 ]View Article PubMed
  Chemoradiotherapy for Cervical Cancer Meta-Analysis Collaboration, 2008. Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: a systematic review and meta-analysis of individual patient data from 18 randomized trials. J. Clin. Oncol., 26(35):5802鈥?812. [doi:10.鈥?200/鈥婮CO.鈥?008.鈥?6.鈥?368 ]View Article PubMed Central
  Chun, K.C., Kim, D.Y., Kim, J.H., et al., 2010. Neoadjuvant chemotherapy with paclitaxel plus platinum followed by radical surgery in early cervical cancer during pregnancy: three case reports. Jpn. J. Clin. Oncol., 40(7):694鈥?98. [doi:10.鈥?093/鈥媕jco/鈥媓yq039 ]View Article PubMed
  Favero, G., Chiantera, V., Oleszczuk, A., et al., 2010. Invasive cervical cancer during pregnancy: laparoscopic nodal evaluation before oncologic treatment delay. Gynecol. Oncol., 118(2):123鈥?27. [doi:10.鈥?016/鈥媕.鈥媦gyno.鈥?010.鈥?4.鈥?12 ]View Article PubMed
  Fruscio, R., Villa, A., Chiari, S., et al., 2012. Delivery delay with neoadjuvant chemotherapy for cervical cancer patients during pregnancy: a series of nine cases and literature review. Gynecol. Oncol., 126(2):192鈥?97. [doi:10.鈥?016/鈥媕.鈥媦gyno.鈥?012.鈥?4.鈥?27 ]View Article PubMed
  Germann, N., Haie-Meder, C., Morice, P., et al., 2005. Management and clinical outcomes of pregnant patients with invasive cervical cancer. Ann. Oncol., 16(3):397鈥?02. [doi:10.鈥?093/鈥媋nnonc/鈥媘di084 ]View Article PubMed
  Greer, B.E., Easterling, T.R., Mclennan, D.A., et al., 1989. Fetal and maternal considerations in the management of stage I-B cervical cancer during pregnancy. Gynecol. Oncol., 34(1):61鈥?5. [doi:10.鈥?016/鈥?090-8258(89)90108-X ]View Article PubMed
  Guo, Q., Shan, Y., Yang, J.X., et al., 2012. Management of invasive cervical cancer in pregnancy: clinical analysis of 13 cases. Chin. J. Obstet. Gynecol., 47(12):893鈥?97 (in Chinese).
  Hunter, M.I., Tewari, K., Monk, B.J., 2008. Cervical neoplasia in pregnancy. Part 2: current treatment of invasive disease. Am. J. Obstet. Gynecol., 199(1):10鈥?8. [doi:10.鈥?016/鈥媕.鈥媋jog.鈥?007.鈥?2.鈥?11 ]
  Lai, C.H., Hsueh, S., Chang, T.C., et al., 1997. Prognostic factors in patients with bulky stage IB or IIA cervical carcinoma undergoing neoadjuvant chemotherapy and radical hysterectomy. Gynecol. Oncol., 64(3):456鈥?62. [doi:10.鈥?006/鈥媑yno.鈥?996.鈥?603 ]View Article PubMed
  Lee, J.M., Lee, K.B., Kim, Y.T., et al., 2008. Cervical cancer associated with pregnancy: results of a multicenter retrospective Korean study (KGOG-1006). Am. J. Obstet. Gynecol., 198(1):92.e1-92.e6. [doi:10.鈥?016/鈥媕.鈥媋jog.鈥?007.鈥?6.鈥?77 ]
  Lee, R.B., Neglia, W., Park, R.C., 1981. Cervical carcinoma in pregnancy. Obstet. Gynecol., 58(5):584鈥?89.PubMed
  Marana, H.R., de Andrade, J.M., da Silva Mathes, A.C., et al., 2001. Chemotherapy in the treatment of locally advanced cervical cancer and pregnancy. Gynecol. Oncol., 80(2):272鈥?74. [doi:10.鈥?006/鈥媑yno.鈥?000.鈥?055 ]View Article PubMed
  Morice, P., Uzan, C., Uzan, S., 2012. Cancer in pregnancy: a challenging conflict of interest. Lancet, 379(9815):495鈥?96. [doi:10.鈥?016/鈥婼0140-6736(11)61814-X ]View Article PubMed
  Nisker, J.A., Shubat, M., 1983. Stage IB cervical carcinoma and pregnancy: report of 49 cases. Am. J. Obstet. Gynecol., 145(2):203鈥?06.PubMed
  Noordhuis, M.G., Eijsink, J.J., Roossink, F., et al., 2011. Prognostic cell biological markers in cervical cancer patients primarily treated with (chemo) radiation: a systematic review. Int. J. Radiat. Oncol. Biol. Phys., 79(2):325鈥?34. [doi:10.鈥?016/鈥媕.鈥媔jrobp.鈥?010.鈥?9.鈥?43 ]View Article PubMed
  Pentheroudakis, G., Pavlidis, N., 2006. Cancer and pregnancy: poena magna, not anymore. Eur. J. Cancer, 42(2):126鈥?40. [doi:10.鈥?016/鈥媕.鈥媏jca.鈥?005.鈥?0.鈥?14 ]View Article PubMed
  Pentheroudakis, G., Orecchia, R., Hoekstra, H.J., et al., 2010. Cancer, fertility and pregnancy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol., 21(Suppl. 5):v266鈥搗273. [doi:10.鈥?093/鈥媋nnonc/鈥媘dq198 ]View Article PubMed
  Rabaiotti, E., Sigismondi, C., Montoli, S., et al., 2010. Management of locally advanced cervical cancer in pregnancy: a case report. Tumori, 96(4):623鈥?26.PubMed
  Smyth, E.C., Korpanty, G., Mccaffrey, J.A., et al., 2010. Small-cell carcinoma of the cervix at 23 weeks gestation. J. Clin. Oncol., 28(18):e295鈥揺297. [doi:10.鈥?200/鈥婮CO.鈥?009.鈥?5.鈥?604 ]View Article PubMed
  Sood, A.K., Sorosky, J.I., 1998. Invasive cervical cancer complicating pregnancy. How to manage the dilemma. Obstet. Gynecol. Clin. North Am., 25(2):343鈥?52. [doi:10.鈥?016/鈥婼0889-8545(05)70009-7 ]View Article
  Stensheim, H., Moller, B., van Dijk, T., et al., 2009. Causespecific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J. Clin. Oncol., 27(1):45鈥?1. [doi:10.鈥?200/鈥婮CO.鈥?008.鈥?7.鈥?110 ]View Article PubMed
  Takushi, M., Moromizato, H., Sakumoto, K., et al., 2002. Management of invasive carcinoma of the uterine cervix associated with pregnancy: outcome of intentional delay in treatment. Gynecol. Oncol., 87(2):185鈥?89. [doi:10.鈥?006/鈥媑yno.鈥?002.鈥?813 ]View Article PubMed
  
• 作者单位：Xiang Zhang (1) (2)
  Yong-liang Gao (1)
  Yue Yang (1)
  
  1. Department of Gynecological Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, China
  2. Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, 310022, China
  
• 刊物主题：Biomedicine general;
• 出版者：Springer Berlin Heidelberg
• ISSN：1862-1783

文摘

This study was designed to investigate the therapeutic approaches and prognosis for cervical cancer associated with pregnancy. Clinical information, therapeutic strategies, and follow-up results of 20 patients with cervical cancer associated with pregnancy from Jan. 2000 to June 2009 in the Zhejiang Cancer Hospital were retrospectively analyzed. The International Federation of Gynecology and Obstetrics (FIGO) stages were: in situ n=1), stage IA1 n=1), stage IB1 n=5), stage IB2 n=1), stage IIA n=8), stage IIB n=3), and stage IIIB n=1). Eight patients were in the first trimester of pregnancy, four in the second, two in the third, and six at postpartum when diagnosed. The therapeutic strategies were either single or combined modalities, including surgery, radiotherapy, and chemotherapy. Fourteen patients survived, five patients died (four of remote metastasis and one of uremia), and one patient was lost to follow-up. One newborn from a patient at stage IIA carcinoma in the third trimester with postponed therapy six weeks after diagnosis survived. Retarded fetal growth was observed in one patient receiving neoadjuvant chemotherapy and cesarean section. Out of the six postpartum patients, three underwent cesarean section and survived, whereas only one out of the three who underwent vaginal delivery survived. The remaining two died of remote metastasis. Therefore, personalized treatment is necessary for cervical cancer associated with pregnancy. Cervical cancer patients in the third trimester of pregnancy can continue the pregnancy for a short period of time. There may be potential risk for the fetus by chemotherapy during pregnancy. Cesarean section is the preferred mode of delivery for pregnant cervical cancer patients.