Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy.
Dipartimento di Scienze della Vita e Sanita Pubblica, Università Cattolica Del Sacro Cuore, 00168 Rome, Italy.
Curr Oncol. 2022 Aug 14;29(8):5702-5714. doi: 10.3390/curroncol29080450.
To date, little and discordant data still exists on the management of cervical cancer (CC) during pregnancy. In this paper, we report our experience of the treatment of these patients analyzing the oncologic, obstetric, and neonatal outcomes.
Between January 2010 and December 2021, 13 patients were diagnosed with CC during pregnancy. All patients underwent platinum-based neoadjuvant chemotherapy (NACT) and 11/13 patients underwent a cesarean radical hysterectomy (CRH).
All 13 patients were diagnosed with squamous-cell carcinoma, FIGO-2018 stage between IB2-IIIC1. The majority of patients had a partial (61.5%) or complete (15.4%) response to NACT. Most patients had a regular course of pregnancy and the obstetric complications observed were gestational diabetes mellitus in 23.1% and IUGR in 15.4% of cases. CRH was performed in the absence of major complications. Only 2 patients (15.4%) had disease recurrence and only 1 patient (7.7%) died of disease. All children are currently healthy. At birth, we observed mainly prematurity-related complications (38.5% respiratory distress syndrome and 7.7% neonatal jaundice) and only a case of congenital malformation (hypospadias). In our pediatric population, we reported a case of malignancy (acute myeloid leukemia).
NACT seems to be safe and efficacious in controlling tumor burden during pregnancy. CRH following NACT appears to be feasible, avoiding repeated surgery and treatment delays. This approach is also reasonably safe from a maternal, obstetric, and neonatal point of view.
迄今为止，关于妊娠期宫颈癌（CC）的管理仍存在少量且不一致的数据。在本文中，我们报告了我们治疗这些患者的经验，分析了肿瘤学、产科和新生儿结局。
2010 年 1 月至 2021 年 12 月期间，13 例患者在妊娠期间被诊断为 CC。所有患者均接受铂类新辅助化疗（NACT），11/13 例患者行剖宫产根治性子宫切除术（CRH）。
所有 13 例患者均被诊断为鳞癌，FIGO-2018 分期为 IB2-IIIC1。大多数患者对 NACT 有部分（61.5%）或完全（15.4%）反应。大多数患者妊娠过程正常，观察到的产科并发症为妊娠糖尿病 23.1%，胎儿生长受限 15.4%。CRH 无重大并发症。仅 2 例患者（15.4%）出现疾病复发，仅 1 例患者（7.7%）死于疾病。所有儿童目前均健康。出生时，我们观察到主要与早产相关的并发症（38.5%呼吸窘迫综合征和 7.7%新生儿黄疸）和仅 1 例先天性畸形（尿道下裂）。在我们的儿科人群中，我们报告了 1 例恶性肿瘤（急性髓系白血病）。
NACT 似乎可安全有效地控制妊娠期肿瘤负荷。NACT 后行 CRH 似乎可行，可避免重复手术和治疗延误。从母亲、产科和新生儿的角度来看，这种方法也是合理安全的。
