Mortality Among Women With Cervical Cancer During or Shortly After a Pregnancy in Denmark 1968 to 2006

Eibye, Simone; Kjær, Susanne K.; Nielsen, Thomas Theis; Mellemkjær, Lene

doi:10.1097/igc.0000000000000708

Cited by 9 publications

(11 citation statements)

References 23 publications

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“…In line with our findings, most recent studies have found no difference in survival for PAC and non-PAC of the cervix [8,15,16,25]. Sood et al [26] reported a worse prognosis if diagnosed postpartum, while Eibye et al [14] reported a higher mortality if diagnosed during pregnancy, also including pregnancies that ended in abortion. We did not have information on abortions, which may have introduced selection bias of estimates for early pregnancy.…”

Section: Discussionsupporting

confidence: 90%

Cancer survival in women diagnosed with pregnancy-associated cancer: An overview using nationwide registry data in Sweden 1970–2018

Johansson¹,

Fredriksson²,

Mellemkjær³

et al. 2021

European Journal of Cancer

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Section: Discussionsupporting

confidence: 90%

Cancer survival in women diagnosed with pregnancy-associated cancer: An overview using nationwide registry data in Sweden 1970–2018

Johansson¹,

Fredriksson²,

Mellemkjær³

et al. 2021

European Journal of Cancer

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“…22 A recently published Danish registry-based study found a hazard ratio for death of 1.77 (95% CI 1.21 to 2.60) in 126 patients with cervical cancer observed during pregnancy. 23 Contrary to that finding, Lee et al reported no difference in 5-year overall survival for 40 stage IB pregnant patients compared with non-pregnant patients (75.0% vs 89.4%, p=0.41). 14 Another matched cohort study of 28 pregnant patients with cervical cancer found a similar prognosis (89.3% vs 98.1%, p=0.09) at a median follow-up of 3.4 and 3.7 years.…”

Section: Discussionmentioning

confidence: 84%

“…Nisker et al reported worse 5-year disease-free survival in 43 stage IB pregnant patients compared with 118 non-pregnant patients (69.8% vs 87.3%, p<0.001) 22. A recently published Danish registry-based study found a hazard ratio for death of 1.77 (95% CI 1.21 to 2.60) in 126 patients with cervical cancer observed during pregnancy 23. Contrary to that finding, Lee et al reported no difference in 5-year overall survival for 40 stage IB pregnant patients compared with non-pregnant patients (75.0% vs 89.4%, p=0.41) 14.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of patients with cervical cancer during pregnancy: a multicenter matched cohort study. An initiative from the International Network on Cancer, Infertility and Pregnancy

Halaška

Uzan²,

Han

et al. 2019

International Journal of Gynecological Cancer

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BackgroundTreatment of cervical cancer during pregnancy is often complex and challenging. This study aimed to analyze current patterns of practice in the management of pregnant patients diagnosed with cervical cancer.MethodsThis was a matched cohort study comprising patients managed for cervical cancer during pregnancy from six European centers. Patient information was retrieved from the dataset of the International Network for Cancer, Infertility and Pregnancy from 1990 to 2012. Each center matched its patients with two non-pregnant controls for age (±5 years) and International Federation of Gynecology and Obstetrics (FIGO) 2009 stage. Information on age, histological type, grade, lymphovascular space invasion, stage, tumor size, method of diagnosis, site of recurrence, delivery, date of recurrence, and date of death was recorded. Progression-free survival was compared using multivariable Cox proportional hazards regression.ResultsA total of 132 pregnant patients and 256 controls were analyzed. The pregnant patients (median age 34 years, range 21–43) were diagnosed at a median gestational age of 18.4 weeks of pregnancy (range 7–39). Stage distribution during pregnancy was 14.4% for stage IA, 47.0% for IB1, 18.9% for IB2, and 19.7% for II-IV. For treatment during pregnancy, 17.4% of the patients underwent surgery, 16.7% received neoadjuvant chemotherapy, 26.5% delayed their treatment, 12.9% had a premature delivery, and 26.5% had their pregnancy terminated. Median follow-up was 84 months (67 months for pregnant and 95 months for non-pregnant patients). The unadjusted hazard ratio of pregnancy for progression-free survival was 1.18 (95% confidence interval 0.74 to 1.88).ConclusionSurgery and chemotherapy is increasingly used in the management of pregnant patients with cervical cancer and prognosis is similar to that of non-pregnant patients.

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“…A recent Danish nationwide cohort study including 6135 cervical cancer patients showed that women diagnosed with cervical cancer during pregnancy (in which significant increases in E2 are observed) are at a higher risk of dying from cervical cancer than those who are not pregnant at the diagnosis of cervical cancer [5]. Similarly, 2 other groups also showed increased mortality for women diagnosed with cervical cancer during pregnancy [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Estrogen stimulates female cancer progression by inducing myeloid-derived suppressive cells: investigations on pregnant and non-pregnant experimental models

et al. 2019

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Objective To investigate the clinical implications of 17β-estradiol (E2) in estrogen receptor α (ERα)-negative female cancer progression as well as the underlying biological mechanisms. Methods Clinical data from 306 locally-advanced cervical cancer (stage IIB-IVA) patients were analyzed in order to investigate the relationships between age, serum E2 levels, and treatment outcomes. Clinical samples, ERα-negative cervical and breast cancer cell lines, and mouse xenograft models of cervical and breast cancers were employed in order to elucidate the mechanisms responsible for the E2- and pregnancy-mediated progression of cervical and breast cancers, with a focus on the role of myeloid-derived suppressor cells (MDSC). Results Younger patients with elevated E2 levels showed significantly shorter progression-free survival ( P = 0.040) and overall survival ( P = 0.039). The exogenous E2 treatment stimulated the mobilization of MDSC from bone marrow and directly augmented their suppressive activities, leading to the progression of ERα-negative cervical and breast cancers. The co-administration of an anti-Gr-1 neutralizing antibody with E2 prevented the E2-mediated induction of MDSC, and attenuated E2-mediated tumor growth in cervical and breast cancer xenografts. Significantly increased MDSC numbers and enhanced tumor growth were observed during pregnancy in mice with cervical or breast cancer. Significantly increased MDSC numbers were also observed during pregnancy in cervical cancer patients. Conclusions E2 facilitates the progression of ERα-negative cervical or breast cancer under non-pregnant and pregnant conditions by inducing MDSC. MDSC inhibition therapy may have therapeutic efficacy in premenopausal or pregnant female cancer patients.

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Mortality Among Women With Cervical Cancer During or Shortly After a Pregnancy in Denmark 1968 to 2006

Abstract: Our results suggest an increased mortality for women diagnosed with cervical cancer during pregnancy, but not among those diagnosed shortly after pregnancy. This finding should be explored further in larger populations.

Cited by 9 publications

References 23 publications

Cancer survival in women diagnosed with pregnancy-associated cancer: An overview using nationwide registry data in Sweden 1970–2018

Cancer survival in women diagnosed with pregnancy-associated cancer: An overview using nationwide registry data in Sweden 1970–2018

Characteristics of patients with cervical cancer during pregnancy: a multicenter matched cohort study. An initiative from the International Network on Cancer, Infertility and Pregnancy

Estrogen stimulates female cancer progression by inducing myeloid-derived suppressive cells: investigations on pregnant and non-pregnant experimental models

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