Outcomes of planned delivery delay in pregnant patients with invasive gynecologic cancer.
BACKGROUND
Pregnancy with invasive gynecologic cancer is a rare condition. It is still unclear whether we can choose planned delay in treatment until maturation of the fetus as a treatment modality for this condition. If there are no adverse effects from the cancer and there is improvement of neonatal outcomes, this treatment modality might be an option for patients with this condition.


METHODS
Eight pregnant patients were diagnosed as having invasive gynecologic cancer between January 1998 and December 2007. Five of them, (four with invasive uterine cervical cancer and one with ovarian cancer) chose planned delay in treatment. The pregnancy courses and prognoses of these patients were studied.


RESULTS
The period of planned delay in treatment varied from 2 weeks to 19 weeks. The period was shorter for patients who had complications. The pain caused by the cancer was the main obstacle to this treatment modality in two patients (one with advanced ovarian cancer and one with uterine cervical cancer). No apparent tumor growth, elevation of tumor markers, or complications induced by the cancer itself were detected in the remaining three patients. Only the patient with advanced ovarian cancer died of the primary disease after the delivery. Fetal outcome was uniformly good for the delayed-treatment group. All the babies are growing well, and no fetal deaths or neonatal deaths occurred.


CONCLUSIONS
Planned delay in treatment to allow for fetal maturity is acceptable in pregnant patients with certain types of invasive gynecologic cancers.
Ishioka
Shin-ichi
S
Department of Obstetrics and Gynecology, Sapporo Medical University, Minami 1-jo, Nishi 16-chome, Chuou-ku, Sapporo, Hokkaido, Japan. ishioka@sapmed.ac.jp
Ezaka
Yoshiaki
Y
Endo
Toshiaki
T
Nagasawa
Kunihiko
K
Shimizu
Ayumi
A
Sato
Akiyasu
A
Inoue
Marie
M
Saito
Tsuyoshi
T
D000032:Abortion, Therapeutic; D000328:Adult; D002585:Cesarean Section; D017024:Chemotherapy, Adjuvant; D005260:Female; D005865:Gestational Age; D006801:Humans; D007044:Hysterectomy; D050498:Live Birth; D008197:Lymph Node Excision; D009361:Neoplasm Invasiveness; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy; D010347:Patient Care Planning; D018579:Patient Selection; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
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