[Cervical cancer in pregnancy--practical recommendations]

Area of Science:

• Gynecologic Oncology
• Reproductive Medicine
• Surgical Oncology

Context:

• Invasive cervical cancer diagnosis during pregnancy presents unique treatment challenges.
• Radical surgery is a primary treatment modality for early-stage cervical cancer.
• Balancing oncologic outcomes with reproductive desires is crucial.

Purpose:

• To evaluate survival outcomes for pregnant patients with invasive cervical cancer undergoing radical surgery.
• To establish therapeutic recommendations for managing cervical cancer in pregnant patients.
• To compare outcomes between pregnant and non-pregnant patients with cervical cancer.

Summary:

• Five-year survival rates were comparable between 20 pregnant women and 541 non-pregnant patients treated with radical surgery for invasive cervical cancer.
• Treatment guidelines suggest postpartum radical surgery for stages Ia to IIb, especially if fertility preservation is desired and cancer is diagnosed after 20 weeks gestation.
• Advanced stages (IIIb-IVb) require immediate definitive therapy, with postpartum treatment recommended for suspected cervical intraepithelial neoplasia grade III.

Impact:

• Provides evidence-based guidelines for managing cervical cancer in pregnant individuals.
• Supports fertility preservation strategies in select cases of cervical cancer.
• Informs clinical decision-making regarding the optimal timing of surgical intervention for cervical cancer during pregnancy.