title: [Management of invasive cervical cancer in pregnancy: clinical analysis of 13 cases].
abstract: OBJECTIVE
  To analyze the clinical characteristics and assess the outcome of treatment for cervical cancer during pregnancy.
  
  
  METHODS
  A cohort of 13 patients with cervical cancer diagnosed during pregnancy from January 2001 to September 2011 in Peking Union Medical College Hospital (PUMCH) was retrospectively studied. Clinical information, gestational age at diagnosis, treatment options and maternal and child outcomes were collected and analyzed.
  
  
  RESULTS
  Thirteen patients out of 2030 cases of invasive cervical cancer were diagnosed during pregnancy with an incidence of 0.64% (13/2030). The Mean gestational age at diagnosis of 13 patients is 21(+6) weeks. Two cases were diagnosed during the first trimester, 8 cases at second trimester and 3 cases at third trimester respectively. Vaginal bleeding during the pregnancy was main clinical manifestation presented in 8 patients and all thirteen cases were diagnosed by biopsy with pathological types of squamous cell carcinoma in 10 cases. The International Federation of Gynecology and Obstetrics (FIGO) stage was I in eleven cases and stage II in two cases. Six patients of them received treatment promptly after diagnosis. The other 7 patients had delayed treatment with mean diagnosis-treatment interval time of 65 days due to fertility reasons, who ended pregnancy by cesarean section at mean gestational age of 34(+6) weeks, two of them received chemotherapy with cisplatin + fluorouracil (PF) or cisplatin respectively before the end of the pregnancy, while the one with PF chemotherapy experienced neonatal death. The rest 6 neonatal outcomes were good. As follow-up of 13 cases: 11 cases in stage I received surgical treatment, and two of which had recurrence respectively, 15 months and 7 months post surgery, and one case had died. One case of Stage II patients died and one had recurrence after 53 months after radiotherapy. The recurrence rate in 13 cases was 3/13 and the mortality rate was 2/13.
  
  
  CONCLUSIONS
  Most cases of cervical cancer diagnosed during pregnancy were in early FIGO stage. For those patients diagnosed in late pregnancy with strong fertility demand, considering delayed treatment according to FIGO stage of the disease and fetus maturity is appropriate. Chemotherapy during pregnancy may cause neonatal complications.
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Qi
authors: Q
authors: Guo
authors: Ying
authors: Y
authors: Shan
authors: Jia-xin
authors: JX
authors: Yang
authors: Jun-tao
authors: JT
authors: Liu
authors: Dong-yan
authors: DY
authors: Cao
authors: Ning-hai
authors: NH
authors: Cheng
authors: Hui-fang
authors: HF
authors: Huang
authors: Ling-ya
authors: LY
authors: Pan
authors: Jing-he
authors: JH
authors: Lang
authors: Keng
authors: K
authors: Shen
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery; D002585:Cesarean Section; D019092:Conization; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents