Department of Gynecologic Surgery, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
Department of Gynecology Oncology, Instituto Nacional de Cancerologia, Bogota, Colombia.
Int J Gynecol Cancer. 2021 Mar;31(3):468-474. doi: 10.1136/ijgc-2020-001764.
To describe oncologic and obstetric outcomes in patients diagnosed with cervical cancer during pregnancy who had a successful delivery after neoadjuvant chemotherapy.
A multicenter retrospective review was conducted in 12 institutions from six Latin American countries, between January 2007 and December 2018. Data collected included clinical characteristics, neoadjuvant chemotherapy agents, treatment, obstetric and oncologic outcomes.
Thirty-three patients were included. Median age was 34 years (range 31-36). Twenty (60.6%) women were diagnosed at early stage (IB), and 13 (39.4%) with locally advanced stage (IIA-IIIB) according to FIGO 2009 classification. Carboplatin and paclitaxel was the most frequent combination used (60.6%). Partial and complete response rates were 27.3% and 9.1%, respectively. Median gestational age at delivery was 35 weeks (range 34-36). All patients had live births delivered by cesarean section. Obstetric pathology: pre-term labor, placenta percreta or intra-uterine growth restriction, was documented in seven patients (21.2%). Two (6.1%) neonates had low birth weight. Definitive treatment was primary chemo-radiation in 19 (57.6%) patients, radical hysterectomy in 11 (33.3%), abandoned radical hysterectomy with para-aortic lymphadenectomy and ovarian transposition in 1 patient (3.0%), and no further treatment in 2 (6.1%) patients. After a median follow-up of 16.3 months (range 2.0-36.9), 8 (26.7%) patients had recurrent disease. Of these, four (13.3%) died due to disease.
Neoadjuvant chemotherapy may be offered to patients wishing to preserve an ongoing pregnancy in order to achieve fetal maturity. Long-term consequences of chemotherapy in the child are yet to be determined.
描述在接受新辅助化疗后成功分娩的妊娠期宫颈癌患者的肿瘤学和产科结局。
对 2007 年 1 月至 2018 年 12 月来自 6 个拉丁美洲国家的 12 家机构进行了一项多中心回顾性研究。收集的数据包括临床特征、新辅助化疗药物、治疗、产科和肿瘤学结局。
共纳入 33 例患者。中位年龄为 34 岁（范围 31-36）。根据 FIGO 2009 分期，20 例（60.6%）患者诊断为早期（IB），13 例（39.4%）为局部晚期（IIA-IIIB）。卡铂联合紫杉醇是最常用的联合方案（60.6%）。部分缓解和完全缓解率分别为 27.3%和 9.1%。中位分娩时孕周为 35 周（范围 34-36）。所有患者均经剖宫产分娩活产儿。产科病理学：早产、胎盘植入或宫内生长受限，在 7 例患者（21.2%）中记录。2 例（6.1%）新生儿体重低。19 例（57.6%）患者接受了根治性放化疗，11 例（33.3%）患者接受了根治性子宫切除术，1 例（3.0%）患者放弃了根治性子宫切除术加腹主动脉淋巴结清扫术和卵巢移位术，2 例（6.1%）患者未进一步治疗。中位随访 16.3 个月（范围 2.0-36.9）后，8 例（26.7%）患者出现疾病复发。其中，4 例（13.3%）因疾病死亡。
为了使胎儿成熟，可向希望保留妊娠的患者提供新辅助化疗。化疗对儿童的长期影响尚待确定。
