Locally Advanced Cervical Cancer in Pregnancy: Overcoming the Challenge. A Case Series and Review of the Literature

Int J Gynecol Cancer. 2016 Oct;26(8):1490-6. doi: 10.1097/IGC.0000000000000795.

Abstract

Objective: Cervical cancer is the most common gynecological cancer occurring in pregnancy, creating a complex situation both for patient and physician. Neoadjuvant chemotherapy is an innovative way of managing cervical cancer in pregnancy.

Methods: In our paper, we report a retrospective case series of 4 women treated with chemotherapy for invasive cervical cancer during pregnancy in our center over the last 5 years, and we summarize the available literature and guidelines.

Results: All the cases were locally advanced cervical cancers that received chemotherapy with platinum and/or taxanes. All patients showed a good response to chemotherapy and a radical surgery was performed with no additional morbidities at the cesarean delivery time in 3 of 4 cases. Three of 4 patients are alive and have a good outcome with no recurrence of disease up to date. One patient died because of recurrent disease 2 years after the first-line treatment during pregnancy. All babies are alive and well up to date (maximum follow-up, 63 months).

Conclusions: Even if there are no standardized practices in the treatment of cervical cancer in pregnancy, in our opinion, neoadjuvant chemotherapy can be a very useful strategy for patients and physicians facing the challenge.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage
  • Cisplatin / therapeutic use
  • Female
  • Humans
  • Neoadjuvant Therapy
  • Paclitaxel / administration & dosage
  • Pregnancy
  • Pregnancy Complications, Neoplastic / drug therapy*
  • Pregnancy Complications, Neoplastic / pathology
  • Pregnancy Complications, Neoplastic / surgery*
  • Pregnancy Outcome
  • Retrospective Studies
  • Uterine Cervical Neoplasms / drug therapy*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*

Substances

  • Paclitaxel
  • Cisplatin