妊娠期宫颈癌的个体化管理。
Individual management of cervical cancer in pregnancy.
作者信息
Hecking Thomas, Abramian Alina, Domröse Christian, Engeln Tabea, Thiesler Thore, Leutner Claudia, Gembruch Ulrich, Keyver-Paik Mignon-Denise, Kuhn Walther, Kübler Kirsten
机构信息
Department of Gynecology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany.
Institute of Pathology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany.
出版信息
Arch Gynecol Obstet. 2016 May;293(5):931-9. doi: 10.1007/s00404-015-3980-y. Epub 2016 Jan 4.
PURPOSE
The management of cervical cancer in pregnancy persists to be challenging. Therefore, identification of factors that influence the choice of therapeutic management is pivotal for an adequate patient counseling.
METHODS
We present a literature review of 26 studies reporting 121 pregnancies affected by cervical cancer. Additionally, we add a retrospective case series of five patients with pregnancy-associated cervical cancer diagnosed and treated in our clinic between 2006 and 2013.
RESULTS
The literature review revealed that the therapeutic management during pregnancy varies according to the gestational age at diagnosis, while in the postpartum period no influence on the treatment choice could be detected. Also in our case series the choice of oncologic therapy was influenced by the gestational age, the wish to continue the pregnancy and the risks of delaying definitive treatment.
CONCLUSIONS
There are no standardized procedures concerning the treatment of cervical cancer in pregnancy. Therefore, in consultation with the patient and a multidisciplinary team, an adequate individualized treatment plan should be determined.
目的
妊娠期宫颈癌的管理仍然具有挑战性。因此，识别影响治疗管理选择的因素对于进行充分的患者咨询至关重要。
方法
我们对26项研究进行了文献综述，这些研究报告了121例受宫颈癌影响的妊娠。此外，我们增加了一个回顾性病例系列，包含2006年至2013年间在我们诊所诊断和治疗的5例妊娠相关宫颈癌患者。
结果
文献综述显示，妊娠期的治疗管理因诊断时的孕周而异，而在产后阶段，未发现对治疗选择有影响。在我们的病例系列中，肿瘤治疗的选择也受到孕周、继续妊娠的意愿以及延迟确定性治疗的风险的影响。
结论
妊娠期宫颈癌的治疗没有标准化程序。因此，应与患者及多学科团队协商，确定适当的个体化治疗方案。
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