Management of Pregnant Women with Invasive Cervical Cancer about Ten Cases

Abstract

The purpose of this study was to update the management of invasive cervical cancers diagnosed during pregnancy. Patients and methods: This study was performed retrospectively at radiotherapy department of National Institute of Oncology Rabat Morocco. From 01/04/2005 to 31/05/2010, ten patients with invasive cervical cancer during pregnancy were included. Results: Ten patients were included in the study. The staging was as follow: stage IIIB (n = 4); stage IIB (n = 2) and stage IB2 (n = 4). The radical abdominal hysterectomy with pelvic lymphadenectomy was performed in five patients; a therapeutic interruption of pregnancy was performed in four patients. One pregnancy has resulted in the birth of a living child (by cesarean section). Adjuvant treatment was concomitant chemoradiotherapy followed by low dose rate (LDR) brachytherapy in three patients; adjuvant concomitant chemoradiotherapy followed by high dose rate (HDR) brachytherapy was performed in four patients; a HDR brachytherapy was done in one patient. Two patients have received an exclusive external radiotherapy. After a median follow-up of 4 years (2 -7 years), there were bone and lung metastases in one patient. Nine patients are alive after completed treatment. Conclusion: Our series focused on ten patients with invasive cervical cancer during pregnancy. Management is complex and requires discussion in a multidisciplinary meeting. Routine screening of cervical cancer and awareness are the key point to improve the treatment and survival rate of patients. The management of all cases is according to international recommendations.