title: [Management of pregnant women with advanced cervical cancer: About five cases observed in Lille from 2002 till 2009. Evaluation of practices referring to the new French recommendations of 2008].
abstract: OBJECTIVE
  An update on the management of invasive cervical cancer (from stage IB) diagnosed during pregnancy with reference to the recent French guidelines.
  
  
  METHODS
  We retrospectively analyzed patients for whom invasive cervical cancer was diagnosed during pregnancy and managed jointly by Jeanne-de-Flandres and Roubaix maternity and by Oscar-Lambret cancer center between 2002 and 2009.
  
  
  RESULTS
  Five patients were included: four stage IB1, and one stage IB2. Five pregnancies resulted in the birth of six alive children. Three patients received neoadjuvant chemotherapy during pregnancy. One patient had a laparoscopic pelvic lymphadenectomy in first trimester. Two laparoscopic extraperitoneal paraortic lymphadenectomy have been made. The mean time of survey is 47.5 months (12-94 months). One patient died of her cancer.
  
  
  CONCLUSIONS
  The diagnosis of cervical cancer during pregnancy involves the same therapeutic guidelines in the absence of pregnancy. The laparoscopic pelvic lymphadenectomy (up to 20 to 24 weeks of gestation) is crucial in the therapeutic treatment for tumors less than 4cm. Neoadjuvant chemotherapy is used during pregnancy for patients refusing medical termination of pregnancy.
authors.affiliation: Service de gynécologie, hôpital Jeanne-de-Flandre, avenue E.-Avinée, CHRU de Lille, 59037 Lille cedex, France. macarillon@hotmail.fr
authors.forename: M-A
authors.initials: MA
authors.lastname: Carillon
authors.forename: V
authors.initials: V
authors.lastname: Emmanuelli
authors.forename: B
authors.initials: B
authors.lastname: Castelain
authors.forename: S
authors.initials: S
authors.lastname: Taieb
authors.forename: P
authors.initials: P
authors.lastname: Collinet
authors.forename: D
authors.initials: D
authors.lastname: Vinatier
authors.forename: A
authors.initials: A
authors.lastname: Lesoin
authors.forename: V
authors.initials: V
authors.lastname: Chevalier-Evain
authors.forename: E
authors.initials: E
authors.lastname: Leblanc
authors.forename: F
authors.initials: F
authors.lastname: Narducci
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology / Q000628:therapy*; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin / Q000502:physiology; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*