Gynecologic Cancers in Pregnancy: Guidelines of a Second International Consensus Meeting

Abstract

Supplementary data on teratogenic effects, ionizing examinations, sentinel lymph node biopsy, tumor markers during pregnancy, as well as additional references and tables are available at the extended online version of this consensus article, go to http://links.lww.com/IGC/A197.

How much platinum passes the placental barrier? Analysis of platinum applications in 21 patients with cervical cancer during pregnancy

“…Therefore, patients should be counseled and treated in clinical institutions with interdisciplinary expert teams. 8,11 Individual treatment plans for all patients within this study were compiled in Research Gynecology ajog.org gynecological-oncological centers of the country in question.…”

“…[2][3][4][5][6][7][8] Management of cervical cancer complicated by pregnancy depends on several factors, such as the stage of disease (tumor size), lymph node involvement, duration of pregnancy, histological subtype, the parent's wish to continue pregnancy, and future child-bearing desire. [9][10][11] There are only a few available guidelines and reviews for the treatment of pregnant women with cervical cancer. [8][9][10][11][12][13][14] However, these recommendations are based on small retrospective cohort studies and few case reports and therefore are limited in their meaningfulness.…”

“…[9][10][11] There are only a few available guidelines and reviews for the treatment of pregnant women with cervical cancer. [8][9][10][11][12][13][14] However, these recommendations are based on small retrospective cohort studies and few case reports and therefore are limited in their meaningfulness. In early cervical cancer, postponing oncological therapy until fetal viability seems to be a safe option, whereas in locally advanced cancer, neoadjuvant platinum-based chemotherapy during the second and third trimesters is recommended to avoid rapid tumor progression until fetal maturity is reached.…”

“…In early cervical cancer, postponing oncological therapy until fetal viability seems to be a safe option, whereas in locally advanced cancer, neoadjuvant platinum-based chemotherapy during the second and third trimesters is recommended to avoid rapid tumor progression until fetal maturity is reached. 1,8,10,11 The feasibility and potential benefits of neoadjuvant chemotherapy derive from retrospective oncological and pediatric outcomes after its use in pregnancy. Although there are accumulating data in the literature concerning the administration of cisplatinum and carboplatinum during pregnancy, the safety of these molecules for the fetus remains uncertain.…”

Kinderwunsch und Schwangerschaft bei Zervixkarzinom und Vorstufen

“…Der Entbindungszeitpunkt muss interdisziplinär im gynäkoonkologisch-neonatologischen Konsens festgelegt werden. Bei hohem Risiko eines schnellen Tumorprogresses kann eine NACT mit Cisplatin begonnen werden [33]. Im extrem seltenen Fall eines fortgeschrittenen Karzinoms (Stadium IIB-IV) sollte unverzüglich die stadienadaptierte Radiochemotherapie mit Cisplatin erfolgen, wobei die Radiatio in der Regel mit einem intrauterinen Fruchttod (IUFT) einhergeht.…”