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Cervical carcinoma during pregnancy: outcome of planned delay in treatment
W van Vliet1, A J van Loon, K A ten Hoor
1Department of Obstetrics and Gynaecology, University Hospital Groningen, The Netherlands.
Objective:
To assess maternal mortality after delayed treatment for invasive carcinoma of the uterine cervix during pregnancy and to improve fetal outcome.
Study Design:
Invasive cervical cancer was diagnosed in 12 pregnant women between 1 January 1977 and 1 January 1996. The medical records were examined retrospectively, and a literature survey was performed.
Results:
The incidence of cervical carcinoma in our population was 1.1 per 10000 pregnancies. Ten patients had FIGO (International Federation of Gynaecology and Obstetrics) stage IB lesions, two patients stage IIA/B. Eight patients had squamous cell carcinoma, four adenocarcinoma. In six patients with a gestation of >20 weeks and stage IB/IIA we postponed treatment for 2 to 10 weeks to optimize fetal outcome. In six patients with a gestation of <20 weeks and stage IB/IIB we recommended immediate radical hysterectomy. Fetal outcome in the delayed-treatment group was excellent. Two patients, one in each group, died after a relapse. The remaining five patients of the delayed-treatment group are disease-free after a median follow-up of 82 months.
Conclusion:
Delayed treatment to achieve greater fetal maturity is a reasonable option for patients with cervix carcinoma of