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  • Title: Cervical carcinoma during pregnancy: outcome of planned delay in treatment.
    Author: van Vliet W, van Loon AJ, ten Hoor KA, Boonstra H.
    Journal: Eur J Obstet Gynecol Reprod Biol; 1998 Aug; 79(2):153-7. PubMed ID: 9720834.
    Abstract:
    OBJECTIVE: To assess maternal mortality after delayed treatment for invasive carcinoma of the uterine cervix during pregnancy and to improve fetal outcome. STUDY DESIGN: Invasive cervical cancer was diagnosed in 12 pregnant women between 1 January 1977 and 1 January 1996. The medical records were examined retrospectively, and a literature survey was performed. RESULTS: The incidence of cervical carcinoma in our population was 1.1 per 10000 pregnancies. Ten patients had FIGO (International Federation of Gynaecology and Obstetrics) stage IB lesions, two patients stage IIA/B. Eight patients had squamous cell carcinoma, four adenocarcinoma. In six patients with a gestation of >20 weeks and stage IB/IIA we postponed treatment for 2 to 10 weeks to optimize fetal outcome. In six patients with a gestation of <20 weeks and stage IB/IIB we recommended immediate radical hysterectomy. Fetal outcome in the delayed-treatment group was excellent. Two patients, one in each group, died after a relapse. The remaining five patients of the delayed-treatment group are disease-free after a median follow-up of 82 months. CONCLUSION: Delayed treatment to achieve greater fetal maturity is a reasonable option for patients with cervix carcinoma of <stage IIB, non-bulky tumours and a gestation of >20 weeks.
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