title: Pathology-oriented treatment strategy of malignant ovarian tumor in pregnant women: analysis of 41 cases in Japan.
abstract: BACKGROUND
  The aim of this study was to investigate the impact of the histological findings on the treatment of malignant ovarian tumors in pregnant women.
  
  
  METHODS
  This is a retrospective study of 41 patients diagnosed and treated for ovarian malignancy during pregnancy between 1985 and 2010.
  
  
  RESULTS
  The median age of the study group was 30 years old, ranging from 20 to 41. Thirty-eight (92 %) patients were diagnosed with stage I, and one (2 %) with each of stages II, III, and IV. Twenty-five (61 %) patients had borderline malignancy, 8 (20 %) were diagnosed with epithelial ovarian cancer, 7 (17 %) with germ cell tumor, and one with sex cord stromal tumor. All patients received primary surgery; 7 (17 %) patients had cystectomy, 32 (78 %) had unilateral salpingo-oophorectomy, and 3 (7 %) underwent hysterectomy with bilateral salpingo-oophorectomy. Thirty-one (76 %) patients delivered live newborns; 21 had borderline tumor (84 %), 2 had ovarian cancers (25 %), and 8 had non-epithelial tumor (100 %). Six cases were terminated in order to perform the standard treatment for ovarian malignancy and 2 cases aborted spontaneously.
  
  
  CONCLUSIONS
  In pregnant women, ovarian cancer is exceptionally less frequent compared with non-pregnant women, i.e. age-matched, statistically-corrected controls based on the Japanese annual report [8/33 (24 %) vs. control (60 %); ovarian cancer/(ovarian cancer + borderline tumor), P = 0.001]. The pregnant women with ovarian cancer chose to prioritize treatment of ovarian cancer at the sacrifice of their babies while those with borderline tumor or non-epithelial tumor were able to successfully deliver live newborns.
authors.affiliation: Department of Obstetrics/Gynecology, Jikei Daisan Hospital, 4-11-1 Izumi-Honchou, Komae, Tokyo, 201-8601, Japan.
authors.forename: Asuka
authors.initials: A
authors.lastname: Morikawa
authors.forename: Kazu
authors.initials: K
authors.lastname: Ueda
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Takahashi
authors.forename: Masaharu
authors.initials: M
authors.lastname: Fukunaga
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Iwashita
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Takechi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umezawa
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Terauchi
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kiguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nomura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Toyomi
authors.initials: T
authors.lastname: Satoh
authors.forename: Toshiko
authors.initials: T
authors.lastname: Jobo
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takei
authors.forename: Seiryu
authors.initials: S
authors.lastname: Kamoi
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Terao
authors.forename: Seiji
authors.initials: S
authors.lastname: Isonishi
mesh_terms: D000328:Adult; D015653:Cystectomy / Q000379:methods; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007564:Japan; D009367:Neoplasm Staging / Q000379:methods; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult