Plum Patrick S, Nowotny Robert, Thieme René, Kreuser Nicole, Gockel Ines
Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany.
Unit of Gastroenterological Surgery, IRCCS San Raffaele Hospital, Milan, Italy.
Visc Med. 2025 Apr;41(2):80-85. doi: 10.1159/000544835. Epub 2025 Feb 20.
Malignant (and benign) tumors of the upper gastrointestinal tract are very rare in pregnancy and can be difficult to diagnose because their symptoms are often misinterpreted as "typical" symptoms of pregnant women like vomiting, nausea, and reflux. Alterations of the female hormones may affect central aspects, such as modulation of immune response and prognosis.
Prolonged "pregnancy-associated" symptoms need further diagnostics in all cases. Once diagnosed, treatment of upper gastrointestinal tumors during pregnancy is based on multimodal treatment approaches depending on the gestational age of the pregnancy and the stage of the tumor and may include chemotherapy and radical surgical resection.
Only little data exist analyzing the treatment modalities of upper gastrointestinal tumors during pregnancy. Nevertheless, this data demonstrates that curative therapeutic options and guideline-related oncologic concepts can safely be performed in pregnant women. In particular, radical oncologic surgical resection is practicable in different stages of pregnancy and should not be delayed. In any case, decisions in regard to therapy have to be made by a group of specialists taking into account the specific circumstances of the individual patient especially gestational age and tumor stage.
上消化道恶性（及良性）肿瘤在孕期非常罕见，且难以诊断，因为其症状常被误解为孕妇的“典型”症状，如呕吐、恶心和反流。女性激素的改变可能会影响一些关键方面，如免疫反应的调节和预后。
所有出现持续“与妊娠相关”症状的情况都需要进一步诊断。一旦确诊，孕期上消化道肿瘤的治疗基于多模式治疗方法，具体取决于孕周和肿瘤分期，可能包括化疗和根治性手术切除。
分析孕期上消化道肿瘤治疗方式的数据很少。然而，这些数据表明，针对孕妇可以安全地采用根治性治疗方案和与指南相关的肿瘤学概念。特别是，根治性肿瘤手术切除在孕期的不同阶段都是可行的，不应延迟。在任何情况下，治疗决策都必须由一组专家根据个体患者的具体情况做出，尤其是孕周和肿瘤分期。
