Locally advanced cervical cancer complicating pregnancy: A case of competing risks from the Catholic University of the Sacred Heart in Rome

Vincenzo, Rosa De; Tortorella, Lucia; Ricci, Caterina; Cavaliere, Anna Franca; Zannoni, Gian Franco; Cefalo, Maria Giuseppina; Scambia, Giovanni; Fagotti, Anna

doi:10.1016/j.ygyno.2018.06.028

Cited by 18 publications

(17 citation statements)

References 67 publications

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“…Furthermore, one infant experienced AML at the age of 22 months and received bone-marrow transplantation. The mother also received antitumor agents with cisplatin plus paclitaxel during pregnancy 50. Few chemotherapy-induced secondary tumors in newborns have been definitively identified, such as leukemia exposure to alkylating agents and bladder cancer exposure to cyclophosphamide 50.…”

Section: Discussionmentioning

confidence: 99%

“…The mother also received antitumor agents with cisplatin plus paclitaxel during pregnancy 50. Few chemotherapy-induced secondary tumors in newborns have been definitively identified, such as leukemia exposure to alkylating agents and bladder cancer exposure to cyclophosphamide 50. In addition, since no chromosomal translocation, such as chromosome 5/5q and/or 7/7q (frequently seen in secondary AML)64 or karyotypic deformities were detected in this baby, we are unable directly to ascribe the development of AML to maternal chemotherapy during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of neoadjuvant platinum-based chemotherapy during the second and third trimester of pregnancy in women with cervical cancer: an updated systematic review and meta-analysis

Song¹,

Liu²,

Lin³

et al. 2018

DDDT

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PurposeTo evaluate the efficacy and safety of neoadjuvant platinum-based chemotherapy during pregnancy in women with cervical cancer.MethodsThe PubMed, Embase, and Cochrane Library databases were fully searched to find eligible studies regarding platinum use during pregnancy in women with cervical cancer from January 1980 to September 2018. Data were extracted from the selected studies independently by two authors. Descriptive statistics were calculated for categorical data (frequency and percentage) and numeration data (mean and SD for normally distributed data and median and range for abnormally distributed data). Survival analyses were performed using Kaplan–Meier survival curves and log-rank tests to estimate overall survival and progression-free survival for all patients.ResultsA total of 39 studies including 88 cervical cancer patients with platinum administration during pregnancy were selected in this meta-analysis, and 64 women provided International Federation of Gynecology and Obstetrics stage information. Among the latter, 56 of 64 (87.5%) were diagnosed with early stages (I and IIA) and the remaining 8 of 64 (12.5%) had advanced stages (IIB, III, and IV). In relation to cisplatin, 86 pregnant women were identified, whereas only 2 pregnant women with carboplatin application were retrieved. Overall, 88 newborns were delivered from 84 pregnancies, including two sets of twins and one set of triplets, among which 71 neonates (71 of 88, 80.7%) were completely healthy at birth. All children were healthy at the end of follow-up (median 17 months, range 0–149.5 months), except one who was diagnosed with retroperitoneal embryonal rhabdomyosarcoma at 5 years old and one who had acute myeloid leukemia at 22 months of age. At the end of follow-up (range 4.75–156 months), 16 of 81 (19.8%) patients were diagnosed with recurrence of cervical cancer, and 11 (90%) of those died because of cancer relapse. Neither median overall survival nor median progression-free survival were reached.ConclusionOur results demonstrated that neoadjuvant platinum-based chemotherapy could be a favorable choice for the management of patients with cervical cancer during the second and third trimesters. To reduce the side effects of chemotherapy, cisplatin might be good to use as monotherapy in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of neoadjuvant platinum-based chemotherapy during the second and third trimester of pregnancy in women with cervical cancer: an updated systematic review and meta-analysis

Song¹,

Liu²,

Lin³

et al. 2018

DDDT

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“…Postoperatively, although initially the new born presented no sign of disease, he developed at 22 months of age an acute myeloid leukaemia and necessitated bone marrow transplantation. The authors did not report any other complication in the new-born or mother's evolution 19 .…”

Section: Locally Advanced Stagesmentioning

confidence: 87%

“…An interesting such case was reported by De Vincenzo et al in 2018 19 ; the authors presented the case of a 35-year-old nulligravid patient diagnosed with a poorly differentiated squamous cell carcinoma during the 27 th week of gestation. At that moment, the tumour was classified as a IB2 lesion, so the patient was treated with two cycles of paclitaxel and cisplatin; the treatment provided a partial response of the tumour so the patient was submitted in the 35 th week of gestation to caesarean section in association with radical hysterectomy, bilateral salpingectomy, ovarian transposition, pelvic and para-aortic infra-mesenteric lymph node dissection.…”

Section: Locally Advanced Stagesmentioning

confidence: 90%

Management of cervical cancer during pregnancy– literature review

Bodog¹,

Bacalbaşa²,

Bălescu³

et al. 2018

Arch Balk Med Union

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Approche du cancer du col utérin pendant la grossesse-revue de la littérature Bien que l'incidence exacte des cas de cancer du col de l'utérus chez la femme enceinte ne soit pas connue, il s'agit sans aucun doute de la tumeur maligne gynécologique la plus courante diagnostiquée pendant la grossesse. L'association entre les deux entités ne semble pas influencer les résultats oncologiques. Cependant, la gestion de ces cas reste un véritable défi pour l'obstétricien et pour le gynéco-oncologue, se battre pour deux vies étant nécessaire. De plus, en raison de la rareté des cas, il n'existe pas de directives standard, la stratégie thérapeutique n'est influencée que par de petites séries de cas et des études observationnelles. Ceci est une revue de la littérature des options thérapeutiques actuelles disponibles pour la gestion de tels cas.

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“…The average GA week of these 24 patients was 35±2 weeks. Thirty-six patients underwent neoadjuvant chemotherapy (NACT) (8)(9)(10)(11)(21)(22)(23)(24)(25).…”

Section: Basic Clinical Information Of 92 Ccp Patientsmentioning

confidence: 99%

Treatment and clinical outcomes of cervical cancer during pregnancy

et al. 2019

Ann. Transl. Med

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Background: This study aims to investigate clinicopathological factors associated with survival rate and treatment of patients with cervical cancer during pregnancy (CCP). Methods: A total of 92 patients diagnosed CCP were retrospectively reviewed. One patient was from Nanfang Hospital of Southern Medical University, 5 patients were from Tongji Hospital, and 86 patients were from case reports in the PubMed database from 1961 to 2019. Patients and tumor characteristics were evaluated. Kaplan-Meier and Cox regression methods were used to analyze the 5-year disease-specific survival (DSS).Results: Most patients (73 cases) were stage I according to the 2018 International Federation of Gynecology and Obstetrics (FIGO) standards. Twelve patients (13.04%) terminated pregnancy once diagnosed. These patients were diagnosed at the mean gestational age (GA) of 11±3 weeks, during early pregnancy. For the rest of the patients (80 cases) who continued pregnancy, the mean GA was 35±2 weeks at delivery. There was a significant difference in survival whether the treatment was performed once diagnosed or not. The 5-year DSS was 75% in adenocarcinoma (AC), 68.5% in squamous cell carcinoma (SCC), and 43.7% in the rare subtype. Among the 38 patients who underwent neoadjuvant chemotherapy (NACT), one patient suffered from spontaneous abortion, and one baby experienced acute myeloid leukemia (AML) ex-FAB (French-American-British)-M7 subtype and received bone marrow transplantation. Other delivered newborns showed no abnormality or malformation. Cox multi-factorial analysis demonstrated that tumor size (2 cm) was an independent overall survival predictor for CCP patients (P<0.05).Conclusions: Tumor size was an independent prognostic factor of survival in CCP patients. Pregnancy has adverse effects on the prognosis of cervical cancer. Personalized treatment is a priority for CCP patients.

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Locally advanced cervical cancer complicating pregnancy: A case of competing risks from the Catholic University of the Sacred Heart in Rome

Cited by 18 publications

References 67 publications

Efficacy of neoadjuvant platinum-based chemotherapy during the second and third trimester of pregnancy in women with cervical cancer: an updated systematic review and meta-analysis

Efficacy of neoadjuvant platinum-based chemotherapy during the second and third trimester of pregnancy in women with cervical cancer: an updated systematic review and meta-analysis

Management of cervical cancer during pregnancy– literature review

Treatment and clinical outcomes of cervical cancer during pregnancy

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