Document Detail

Early invasive cervical cancer during pregnancy: different therapeutic options to preserve fertility.
MedLine Citation:
PMID:  22617478     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Cervical cancer is the second most common cancer diagnosed during pregnancy. Conservative management is possible, and different options should be discussed with patients. The main decision parameters are stage of disease, lymph node status, trimester of pregnancy and wishes of the patient. We reviewed our experience on cases of early-stage cervical cancer discovered during pregnancy and treated with different options of fertility-sparing management.
MATERIALS AND METHODS: Between 1990 and 2010, 5 patients with early-stage cervical cancer diagnosed during pregnancy were referred to our department for fertility-sparing treatment. The mean age at diagnosis was 28.6 years (range, 26-30 years). The stages of the tumors according to the International Federation of Gynecology and Obstetrics were IA2 in 2 women and IB1 in 3 women. The histological type was squamous carcinoma in 3 cases and adenocarcinoma in 2 cases. All patients willing to preserve their fertility were treated with vaginal radical trachelectomy (VRT) and pelvic lymph nodes dissection (PLN-D).
RESULTS: Three procedures were performed in the first trimester: 1 patient was treated with medical abortion and then VRT and PLN-D, 2 patients were submitted to VRT and PLN-D during the first trimester, and 1 patient's case was complicated by spontaneous abortion. One patient was observed during the second trimester (20 weeks of gestation) and treated with VRT and PLN-D during pregnancy. Because this patient had pelvic lymph nodes positive for cancer, a cesarean delivery (CD) with radical hysterectomy and para-aortic lymph nodes dissection was performed followed by chemoradiotherapy. The last patient was evaluated during the third trimester of her pregnancy. Treatment included CD followed by VRT and PLN-D, which was delayed, to allow fetal maturity.
CONCLUSIONS: Diagnosis of cervical cancer can occur during pregnancy. Different options of fertility-sparing treatment can be discussed on the basis of several factors: tumor stage, gestational age, and the patient's desire regarding fertility and pregnancy sparing.
Domenico Ferraioli; Domenico Ferriaoli; Annie Buenerd; Pierangelo Marchiolè; Sergio Constantini; Pier Luigi Venturini; Patrice Mathevet
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of gynecological cancer : official journal of the International Gynecological Cancer Society     Volume:  22     ISSN:  1525-1438     ISO Abbreviation:  Int. J. Gynecol. Cancer     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-30     Completed Date:  2012-10-16     Revised Date:  2013-04-03    
Medline Journal Info:
Nlm Unique ID:  9111626     Medline TA:  Int J Gynecol Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  842-9     Citation Subset:  IM    
Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genoa, Genoa, Italy.
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MeSH Terms
Adenocarcinoma / pathology,  therapy*
Carcinoma, Squamous Cell / pathology,  therapy*
Combined Modality Therapy
Fertility Preservation / methods*
Follow-Up Studies
Infertility, Female / prevention & control*
Lymph Node Excision
Neoplasm Invasiveness
Neoplasm Staging
Pregnancy Complications, Neoplastic / prevention & control*
Uterine Cervical Neoplasms / pathology,  therapy*
Erratum In:
Int J Gynecol Cancer. 2013 Mar;23(3):586
Note: Ferriaoli, Domenico [corrected to Ferraioli, Domenico]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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