Cervical carcinoma and pregnancy

Abortion and conization of the cervix is the treatment of choice for patients with preinvasive cervical carcinoma combined with first-term pregnancy. With the second and third term, the pregnancy is led to delivery and a secondary examination is carried out. In case of preienvasive carcinoma only conization of the cervix is performed. In late-term pregnancy the surgical operation starts with a cesarean section. A combination of cervical carcinoma and pregnancy was observed in 31 (44%) of 6,890 patients admitted to the Gynecological Clinic of the National Cancer Center from 1964-2001. Of 1,911 patients with radical hysterectomy (Stage I--58.4%, Stage II--21.8%, Stage III--20%) a combination of cervical carcinoma and pregnancy was diagnosed in 31 women [Stage I--23 (74.2%), Stage II--4 (12.9%), Stage III--4 (12.9%)]; 93.5% of the patients had a first or second term pregnancy. Five-year survival of the patients with surgery only was 83.3%, while with combined therapy--60%. Twenty-nine percent of the patients were 30 and younger. Pregnancy contributed to early manifestation of cervical cancer and did not favor the aggression of malignant tumor growth. The five-year survival rate of patients without staging and those combined with pregnancy was 72.7%; five-year survival rate of patients with early pregnancy was worse compared to those with second or third term pregnancies. Pregnancy is not a contraindication for performance of radical hysterectomy.