Document Detail


Laparoscopic pelvic lymphadenectomy in a patient with cervical cancer stage Ib1 complicated by a twin pregnancy.
MedLine Citation:
PMID:  20129346     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cervical cancer is the most frequently observed malignancy during pregnancy. The presence of nodal metastasis is the most important negative predictor factor, and its assessment is crucial in deciding whether the pregnancy can safely continue. To our knowledge, this is the first report of a twin pregnancy complicated by cancer of the uterine cervix that was successfully treated with laparoscopic pelvic lymphadenectomy and subsequently with neoadjuvant chemotherapy. A 35-year-old woman, gravida 2, para 1, with a dichorionic-diamniotic twin pregnancy underwent laparoscopic staging of the pelvic lymph nodes at 17 weeks of gestation. Cervical adenocarcinoma, grade 2, stage 1b1 with lymphovascular space invasion was diagnosed. Nineteen negative nodes were removed, and the patient was counseled to continue the pregnancy. On the basis of tumor size and detection of lymphovascular space invasion, cisplatin as neoadjuvant chemotherapy was administered until week 32 of gestation, when a cesarean section delivery was performed, along with radical hysterectomy. No complications to the neonates or to the mother due to the therapy were observed. This case demonstrates the safety of operative nodal staging during gestation, even in a twin pregnancy. Exclusion of nodal metastasis may improve oncologic outcomes, and neoadjuvant chemotherapy should be administered when indicated.
Authors:
Giovanni Favero; Malgorzata Lanowska; Achim Schneider; Simone Marnitz; Christhardt K?hler
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  17     ISSN:  1553-4650     ISO Abbreviation:  J Minim Invasive Gynecol     Publication Date:    2010 Jan-Feb
Date Detail:
Created Date:  2010-02-04     Completed Date:  2010-03-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101235322     Medline TA:  J Minim Invasive Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  118-20     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 AAGL. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Gynecology, Charite Universit?tsmedizin, Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / drug therapy,  pathology,  surgery*
Adult
Antineoplastic Agents / therapeutic use
Chemotherapy, Adjuvant
Cisplatin / therapeutic use
Female
Humans
Hysterectomy
Laparoscopy
Lymph Node Excision*
Neoplasm Staging
Pelvis / pathology,  surgery
Pregnancy
Pregnancy Complications, Neoplastic / drug therapy,  pathology,  surgery*
Pregnancy, Multiple*
Treatment Outcome
Twins
Uterine Cervical Neoplasms / drug therapy,  pathology,  surgery*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 15663-27-1/Cisplatin

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


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