Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, No. 20 Section Three, South Renmin Road, Chengdu, 610041, Sichuan Province, People's Republic of China.
BMC Womens Health. 2022 Jul 25;22(1):314. doi: 10.1186/s12905-022-01885-w.
Cervical cancer diagnosed during pregnancy is a rare event, and data regarding efficacy of cancer treatment during pregnancy is limited. This study aimed to assess the safety of continuation of the pregnancy for mother and fetus when concomitantly diagnosed with cervical cancer.
This study retrospectively analyzed all cervical cancer patients diagnosed while pregnant or immediately postpartum, inclusive from Jan 2010 to June 2019 at our institute. Patient clinical details and follow-up were obtained from hospital records.
The study comprised 40 patients with clinical cancer stages of IA1 (1/40, 2.5%); IB1 (15/40, 37.5%); IB2 (10/40, 25%); IIA (12/40, 30%); and IIB (2/40, 5%). There were 38 patients diagnosed during pregnancy, and 2 diagnosed in the postpartum period. Of the 38 patients, 17 were diagnosed in the first trimester, 13 in the second trimester, and 8 in the third trimester. 10 of 38 patients (26.3%) continued their pregnancy after learning of their diagnosis; 7 (70%) in the third trimester and 3 (30%) in the second trimester. The mean time from diagnosis to surgery in the patients who continued their pregnancy was 52.7 days, which was statistically significantly greater than the termination of pregnancy group (52.7 vs. 16.3 days, P < 0.01). Notably, there was no survival difference between the 2 groups (100% vs. 90.91%, P = 0.54), and none of the pregnant women who ultimately died had delayed treatment due to pregnancy. Similarly, the surgical estimated blood loss and operative duration comparison in the 2 groups were not significantly different.
In the present study, the gestational age of pregnancy at the time of initial diagnosis of cervical cancer was an important determinant in the disease management. Continuation of the pregnancy when diagnosed with cervical cancer may not affect the oncologic outcome of the mother nor increase either surgical or obstetric complications. Additionally, the use of neoadjuvant chemotherapy did not threaten the health of the fetus. These results may be useful in counseling patients facing the diagnosis of cervical cancer during pregnancy.
妊娠期宫颈癌较为罕见，目前关于妊娠期癌症治疗效果的数据有限。本研究旨在评估同时诊断出宫颈癌时继续妊娠对母婴的安全性。
本研究回顾性分析了 2010 年 1 月至 2019 年 6 月在我院诊断为宫颈癌的所有孕妇或产后即刻患者。从医院病历中获取患者的临床详细资料和随访信息。
本研究纳入了 40 名具有临床癌症分期的患者，IA1 期（1/40，2.5%）1 例；IB1 期（15/40，37.5%）15 例；IB2 期（10/40，25%）10 例；IIA 期（12/40，30%）12 例；和 IIB 期（2/40，5%）2 例。38 例患者在妊娠期间诊断出宫颈癌，2 例在产后诊断。在 38 例患者中，17 例在孕早期诊断，13 例在孕中期诊断，8 例在孕晚期诊断。在得知诊断结果后，38 例患者中有 10 例（26.3%）继续妊娠；其中 7 例（70%）在孕晚期，3 例（30%）在孕中期。继续妊娠的患者从诊断到手术的平均时间为 52.7 天，明显长于终止妊娠组（52.7 天比 16.3 天，P<0.01）。值得注意的是，两组的生存率无差异（100%比 90.91%，P=0.54），最终死亡的孕妇均未因妊娠而延迟治疗。同样，两组的手术估计出血量和手术时间比较也无显著差异。
本研究中，宫颈癌初始诊断时的妊娠周数是疾病管理的重要决定因素。当诊断出宫颈癌时继续妊娠可能不会影响母婴的肿瘤学结局，也不会增加手术或产科并发症。此外，新辅助化疗的使用不会威胁胎儿的健康。这些结果可能有助于为面临妊娠期宫颈癌诊断的患者提供咨询。
