Pei Yaping, Gou Yuanfeng, Li Na, Yang Xiaojuan, Han Xue, Huiling Liu
Department of Clinical Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, China.
Department of Gynecology and Obstetrics, Gansu Provincial Hospital, Donggang West Road, Lanzhou, 730000, China.
Oncol Ther. 2022 Jun;10(1):55-73. doi: 10.1007/s40487-021-00179-9. Epub 2021 Dec 4.
Based on the available data on ovarian cancer during pregnancy, we performed a review and meta-analysis to evaluate the efficacy and safety of platinum-based chemotherapy against ovarian cancer during pregnancy.
We systematically searched three databases including the PubMed, Embase, and Cochrane Library databases for articles published from January 1986 to December 2020 using the following terms: "ovarian tumors OR ovarian carcinoma OR adnexal masses OR ovarian cancer" AND "pregnancy" AND "chemotherapy." Two authors (Yaping Pei and Yuanfeng Gou) independently searched the literature and extracted data from each eligible study. The outcome measures were overall survival (OS) and progression-free survival (PFS). The OS and PFS of all patients were estimated by Kaplan-Meier survival curves and log-rank tests.
A total of 43 studies including 55 cases of ovarian cancer during pregnancy were selected. Forty-eight patients were comprehensively staged using the International Federation of Gynecology and Obstetrics (FIGO) staging system. Twenty-six of the 48 patients (54.17%) were diagnosed with early-stage disease, while the remaining had advanced stages (II, III, and IV). The mean age at diagnosis was 29.31 years. The majority of patients in this meta-analysis were diagnosed at a mean gestational age of 16.05 weeks. The mean GA at chemotherapy administration was 17.42 weeks. Overall, 55 women gave birth to 56 newborns, including a pair of twins. At the end of follow-up (median 10 months, range 0-73 months), all the children were healthy, except for one child who died 5 days after delivery due to a congenital abnormality. During 2-204 months of follow-up, there were five cases of recurrence, with no evidence of recurrence in the remaining cases. Unfortunately, one patient died 29 months after diagnosis. Neither median overall survival nor median progression-free survival was obtained.
Platinum-based chemotherapy may be a good choice for pregnant women with ovarian cancer who want to continue their pregnancy.
基于现有的关于妊娠期卵巢癌的数据，我们进行了一项综述和荟萃分析，以评估铂类化疗治疗妊娠期卵巢癌的疗效和安全性。
我们系统检索了三个数据库，包括PubMed、Embase和Cochrane图书馆数据库，使用以下检索词查找1986年1月至2020年12月发表的文章：“卵巢肿瘤或卵巢癌或附件肿块或卵巢癌”以及“妊娠”和“化疗”。两位作者（裴亚萍和苟元峰）独立检索文献并从每项符合条件的研究中提取数据。结局指标为总生存期（OS）和无进展生存期（PFS）。所有患者的OS和PFS通过Kaplan-Meier生存曲线和对数秩检验进行估计。
共纳入43项研究，包括55例妊娠期卵巢癌病例。48例患者使用国际妇产科联盟（FIGO）分期系统进行了全面分期。48例患者中有26例（54.17%）被诊断为早期疾病，其余为晚期（II、III和IV期）。诊断时的平均年龄为29.31岁。该荟萃分析中的大多数患者在平均妊娠16.05周时被诊断。化疗时的平均孕周为17.42周。总体而言，55名女性产下了56名新生儿，包括一对双胞胎。在随访结束时（中位随访10个月，范围0 - 73个月），除一名儿童因先天性异常在出生后5天死亡外，所有儿童均健康。在2 - 204个月的随访期间，有5例复发，其余病例无复发证据。不幸的是，一名患者在诊断后29个月死亡。未获得中位总生存期和中位无进展生存期。
对于希望继续妊娠的妊娠期卵巢癌孕妇，铂类化疗可能是一个不错的选择。
