Ji Yong Il, Kim Ki Tae
Department of Obstetrics and Gynecology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Obstet Gynecol Sci. 2013 Sep;56(5):289-300. doi: 10.5468/ogs.2013.56.5.289. Epub 2013 Sep 14.
Gynecologic malignancy during pregnancy is a stressful problem. For the diagnosis and treatment of malignancy during pregnancy, a multidisciplinary approach is needed. Patients should be advised about the benefits and risk of treatment. When selecting a treatment for malignancy during pregnancy, the physiologic changes that occur with the pregnancy should be considered. Various diagnostic procedures that do not harm the fetus can be used. Laparoscopic surgery or laparotomy may be safely performed. The staging approach and treatment should be standard. Systemic chemotherapy during the first trimester should be delayed if possible. Radiation therapy should preferably start postpartum. Although delivery should be delayed preferably until after 35 weeks of gestation, termination of pregnancy may be considered when immediate treatment is required. Subsequent pregnancies do not increase the risk of malignancy recurrence.
妊娠期妇科恶性肿瘤是一个令人倍感压力的问题。对于妊娠期恶性肿瘤的诊断和治疗,需要采用多学科方法。应向患者告知治疗的益处和风险。在选择妊娠期恶性肿瘤的治疗方法时,应考虑妊娠期间发生的生理变化。可采用各种不伤害胎儿的诊断程序。腹腔镜手术或剖腹手术可安全进行。分期方法和治疗应规范。如果可能,孕早期的全身化疗应推迟。放射治疗最好在产后开始。虽然分娩最好推迟到妊娠35周后,但在需要立即治疗时可考虑终止妊娠。后续妊娠不会增加恶性肿瘤复发的风险。