Xing Naidong, Wang Lihui, Sui Xinlei, Zhao Chunru, Huang Yan, Peng Jin
Department of Urology, Qilu Hospital of Shandong University, Jinan 250001, China.
Gynecology Center, Qingdao Women and Children's Hospital, Qingdao 266034, China.
J Clin Med. 2022 Dec 19;11(24):7520. doi: 10.3390/jcm11247520.
Data on epidemiologic features, treatments and outcomes in women diagnosed with ovarian malignancy during pregnancy are very sparse due to its low incidence. The goal of our study was to summarize the epidemiologic characteristics of pregnant women complicated with ovarian malignancy and investigate the safety and efficacy of chemotherapy during pregnancy.
We retrospectively analyzed the clinicopathological data of eight patients suffering from ovarian malignancy during pregnancy in our institution from June 2011 to July 2021. Furthermore, a systematic literature search was conducted in PubMed up to 1 September 2021, which identified 92 cases with ovarian malignancy during pregnancy eligible for the analysis. Therefore, we collected the data of 100 pregnant patients complicated with ovarian malignancy, including clinical demographics, tumor characteristics, treatment interventions and outcomes.
In total, 100 pregnant patients complicated with ovarian malignancy were investigated and classified into three groups: 34 cases in the epithelial ovarian cancer (EOC) group, 38 cases in the germ cell tumors (GCTs) group and 28 cases in the sex cord-stromal tumors (SCSTs) group. The onset age of pregnant patients with epithelial ovarian cancer was significantly higher than that of other patients. Pelvic mass and abdominal pain were the common clinical presentations of pregnant patients with ovarian malignancy. For distinguishing epithelial ovarian cancer during pregnancy, the area under the curve (AUC) of CA-125 was 0.718 with an optimal cutoff value of 58.2 U/mL. Moreover, 53 patients underwent surgery during pregnancy, the majority of whom underwent unilateral adnexectomy in the second trimester. Furthermore, 43 patients received chemotherapy during pregnancy, and 28 delivered completely healthy newborns at birth; 13 neonates showed transient abnormalities without further complications; and 2 died during the neonatal period.
Our study reveals the safety of chemotherapy for ovarian malignancy during pregnancy. However, large-sample prospective studies are still needed to further explore the safety of chemotherapy in pregnant patients with malignancy to choose the appropriate chemotherapy regimen and achieve the maximum benefit for patients.
由于妊娠合并卵巢恶性肿瘤的发病率较低，关于其流行病学特征、治疗方法及结局的数据非常稀少。本研究的目的是总结妊娠合并卵巢恶性肿瘤孕妇的流行病学特征，并探讨孕期化疗的安全性和有效性。
我们回顾性分析了2011年6月至2021年7月在我院就诊的8例妊娠合并卵巢恶性肿瘤患者的临床病理资料。此外，截至2021年9月1日在PubMed上进行了系统的文献检索，确定了92例妊娠合并卵巢恶性肿瘤且符合分析条件的病例。因此，我们收集了100例妊娠合并卵巢恶性肿瘤患者的数据，包括临床人口统计学、肿瘤特征、治疗干预措施及结局。
共调查了100例妊娠合并卵巢恶性肿瘤患者，并将其分为三组：上皮性卵巢癌（EOC）组34例，生殖细胞肿瘤（GCTs）组38例，性索间质肿瘤（SCSTs）组28例。上皮性卵巢癌孕妇的发病年龄显著高于其他患者。盆腔肿块和腹痛是妊娠合并卵巢恶性肿瘤患者的常见临床表现。对于孕期鉴别上皮性卵巢癌，CA-125的曲线下面积（AUC）为0.718，最佳临界值为58.2 U/mL。此外，53例患者在孕期接受了手术，其中大多数在孕中期进行了单侧附件切除术。此外，43例患者在孕期接受了化疗，28例患者分娩时新生儿完全健康；13例新生儿出现短暂异常但无进一步并发症；2例在新生儿期死亡。
我们的研究揭示了孕期化疗治疗卵巢恶性肿瘤的安全性。然而，仍需要大样本前瞻性研究进一步探索恶性肿瘤孕妇化疗的安全性，以选择合适的化疗方案，为患者实现最大获益。
