title: Management and outcome of ovarian malignancy complicating pregnancy: an analysis of 41 cases and review of the literature.
abstract: OBJECTIVE
  The aims of this study are to summarize our experience of managing ovarian malignancy complicating pregnancy, to discuss the maternal and fetal outcomes, and to review the literature concerned.
  
  
  METHODS
  Forty-one patients with ovarian malignancies complicating pregnancy at Peking Union Medical College Hospital between 1990 and 2012 were retrospectively reviewed.
  
  
  RESULTS
  Of the 41 patients, malignancies included epithelial ovarian cancers (13/41, 31.7 %), epithelial borderline ovarian tumors (12/41, 29.3 %), ovarian malignant germ cell tumors (10/41, 24.4 %), sexcord stromal tumors (3/41, 7.3 %), metastatic ovarian tumors (2/41, 4.9 %), and primary ovarian choriocarcinoma (1/41, 2.4 %). The median overall survival was 30 months (range 3-165), with an overall mortality rate of 24.4 %. The pregnancy outcomes included termination in the first trimester (8/41, 19.5 %), full-term vaginal delivery (7/41, 17.0 %), full-term cesarean section (17/41, 41.5 %), and therapeutic cesarean section for premature birth (9/41, 22.0 %). One preterm newborn died, and the remaining 32 survived in healthy status. All patients underwent surgery, and those who deliberately delayed radical surgery had gloomy prognosis. Two patients received chemotherapy during pregnancy, and 24 patients started chemotherapy after pregnancy termination.
  
  
  CONCLUSIONS
  Management priority should be given to the malignancy of ovarian tumors at any stage of pregnancy. Surgical intervention is the main treatment modality, and delaying of radical surgery is not recommended for patients with suspicion of high malignancy. Early diagnosis and appropriate treatment could offer satisfactory prognosis.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
authors.forename: T
authors.initials: T
authors.lastname: Gui
authors.forename: D
authors.initials: D
authors.lastname: Cao
authors.forename: K
authors.initials: K
authors.lastname: Shen
authors.forename: J
authors.initials: J
authors.lastname: Yang
authors.forename: C
authors.initials: C
authors.lastname: Fu
authors.forename: J
authors.initials: J
authors.lastname: Lang
authors.forename: X
authors.initials: X
authors.lastname: Liu
mesh_terms: D000328:Adult; D019468:Disease Management; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000601:surgery; D011256:Pregnancy Outcome