Pregnancy-related cervical cancer in the material of the Regional Cancer Centre, Łódź, between 2011 and 2014

Abstract

Introduction. Pregnancy-related cancer is defined as cancer diagnosed during pregnancy or in the first postpartum year. Cervical cancer affects approximately 1 in 1000 pregnant women and is the most common malignancy affecting pregnancy. We retrospectively analysed the clinical outcome and results of treatment in patients with pregnancy--related cervical cancer. Material and methods. We retrospectively analysed the medical records of nine patients with invasive cervical cancer diagnosed during pregnancy and the postpartum period who had been treated in the Regional Oncological Centre, Łódź, between 2011-2014. Results. Three patients with cervical cancer at stage I were diagnosed between the 14 th and 17 th week of pregnancy afterwards and underwent radical surgery. Two patients with cervical cancer at stage Ib who were diagnosed in the 19 th and 24 th week of gestation decided to continue pregnancy until the 30 th and 32 nd week; then a cesarean section combined with radical surgery was performed. In three patients with inoperative cervical cancer diagnosed between the 26 th and 28 th week of pregnancy, a cesarean section was performed at week 30-32. In one patient cervical cancer at stage IIb was diagnosed during the post-partum period. All patients were treated using intensity-modulated radiotherapy (IMRT) to a total dose of 44 Gy/2Gy, weekly cisplatin (40 mg/m 2 ) concurrent with radiotherapy and brachytherapy. No toxicity was observed. During follow-up, two patients with inoperable cervical cancer were diagnosed with a recurrence 2 and 10 months after treatment, respectively. Conclusions. The management of pregnancy-related cervical cancer is mainly determined by the week of the pregnancy and the stage of the disease at diagnosis, but also by the patient choice. The general condition and follow-up of newborns from pregnancies complicated by cervical cancer are similar to those of newborns arising from non--complicated pregnancies. Treatment toxicity is similar in cases with pregnancy-related cervical cancer and in non--pregnant women with cervical cancer. The major prognostic factor in pregnancy-related cervical cancer remains the stage of the disease at diagnosis. NOWOTWORY J Oncol 2016; 66, 5: 359-366

Sexual well being of breast cancer patients

“…Proper breast oncology surveillance during pregnancy, using safe and inexpensive methods including ultrasonography and biopsy of suspicious masses, can ensure the prevention of cancer development and progression [36]. The stage of the disease at diagnosis is also a major prognostic factor in pregnancy-related cervical cancer [37].…”

Management of cervical cancer during pregnancy – a systematic review

“…Moreover, the choice of treatment regimen is highly dependent on the gestational age at the time of diagnosis. Hence, during the first trimester, a standard of care adequate to the FIGO stage and pregnancy termination is preferred [17,18]. During the second or third trimester, neoadjuvant chemotherapy or definitive treatment delay and induction of delivery are used, respectively.…”

“…Spontaneous delivery is associated with a negative prognosis [9]. Therefore, in the management of invasive cervical cancer, caesarean section is the preferred method of delivery, followed by definitive treatment [7,14,18,27]. This type of schedule may decrease the risk of neoplastic cell implantation in the episiotomy scar as well as reduce metastasis spreading during vaginal delivery [14,15].…”

Cervical cancer in pregnant women. How does it affect the course of pregnancy. Methods of diagnosis and treatment.

“…Podstawowym czynnikiem decydującym o rokowaniu dla chorych na raka szyjki macicy pozostaje stopień zaawansowania nowotowru w momecnie rozpoznania choroby. [18] Leczenie raka szyjki macicy w czasie ciąży jest najtrudniejsze, ponieważ wpływa na samą ciężarną macicę.…”

“…Jest najczęściej rozpoznawanym nowotworem podczas ciąży. [18] Należy pamiętać, że leczenie pacjenta jest leczeniem indywidualnym i należy podejść do każdego jako do oddzielnej jednostki. Czynnikami różniącymi chorych od siebie jest rak wykryty w różnym stadium, pacjent chorujący przewlekle bądź nie, co również przekłada się na przebieg procesu leczniczego.…”