Outcomes of planned delivery delay in pregnant patients with invasive gynecologic cancer

Abstract

Planned delay in treatment to allow for fetal maturity is acceptable in pregnant patients with certain types of invasive gynecologic cancers.

Cisplatin Application in Pregnancy: First in vivo Analysis of 7 Patients

“…Especially in the second trimester of pregnancy, cervical cancer is an oncologic challenge that requires multidisciplinary expertise to recommend continuation or termination of pregnancy [2]. There are only few national guidelines and consensus statements for the treatment of pregnant women with cervical cancer [1,2,3,4,5]. However, these recommendations are based on limited knowledge due to a small number of reported patients and a lack of large studies in this field.…”

“…The spectrum of possible treatment options in the second trimester comprises radical hysterectomy with fetus in situ or in combination with a caesarean section [12], radical abdominal trachelectomy [13], radical vaginal trachelectomy [14], chemotherapy and conization [15], (laparoscopic staging followed by) neoadjuvant chemotherapy and radical hysterectomy after caesarean section [16,17], neoadjuvant chemotherapy followed by caesarean section plus chemoradiation [18], primary chemoradiation with/without evacuation of the uterus [19], neoadjuvant chemotherapy followed by delivery and definitive chemoradiation [9], and delay of delivery until fetal maturity and initiation of oncologic therapy after delivery [1,4]. …”

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

“…[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.…”

Strahlentherapie in der Schwangerschaft

“…Je nach Alter des Kindes und Wachstumsgeschwindigkeit des Tumors ist das Abwarten bis zum Geburtstermin oder bis zur ausreichenden Reife des Kindes und vorzeitigen Entbindung per Kaiserschnitt eine wichtige Option. Über Therapieverzöge-rungen bis zu 32 Wochen wurde berichtet, wobei die Krankheit bei der Mehrzahl der Patientinnen nur langsam progredient war [17,64]. Schmerzen waren die Hauptsymptome [17].…”

“…Über Therapieverzöge-rungen bis zu 32 Wochen wurde berichtet, wobei die Krankheit bei der Mehrzahl der Patientinnen nur langsam progredient war [17,64]. Schmerzen waren die Hauptsymptome [17]. Die Prognose des Zervixkarzinoms während der Schwangerschaft unterscheidet sich nicht wesentlich von der in anderen Lebensphasen [63].…”