Cervical carcinoma during pregnancy: outcome of planned delay in treatment.
OBJECTIVE
To assess maternal mortality after delayed treatment for invasive carcinoma of the uterine cervix during pregnancy and to improve fetal outcome.


METHODS
Invasive cervical cancer was diagnosed in 12 pregnant women between 1 January 1977 and 1 January 1996. The medical records were examined retrospectively, and a literature survey was performed.


RESULTS
The incidence of cervical carcinoma in our population was 1.1 per 10000 pregnancies. Ten patients had FIGO (International Federation of Gynaecology and Obstetrics) stage IB lesions, two patients stage IIA/B. Eight patients had squamous cell carcinoma, four adenocarcinoma. In six patients with a gestation of >20 weeks and stage IB/IIA we postponed treatment for 2 to 10 weeks to optimize fetal outcome. In six patients with a gestation of <20 weeks and stage IB/IIB we recommended immediate radical hysterectomy. Fetal outcome in the delayed-treatment group was excellent. Two patients, one in each group, died after a relapse. The remaining five patients of the delayed-treatment group are disease-free after a median follow-up of 82 months.


CONCLUSIONS
Delayed treatment to achieve greater fetal maturity is a reasonable option for patients with cervix carcinoma of <stage IIB, non-bulky tumours and a gestation of >20 weeks.
Department of Obstetrics and Gynaecology, University Hospital Groningen, The Netherlands.
W
W
van Vliet
A J
AJ
van Loon
K A
KA
ten Hoor
H
H
Boonstra
D000230:Adenocarcinoma / Q000628:therapy*; D000951:Antigens, Neoplasm / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000628:therapy*; D015843:Serpins; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000628:therapy*
D000951:Antigens, Neoplasm; D015843:Serpins; C051072:squamous cell carcinoma-related antigen