Neoadjuvant chemotherapy in pregnant patients with cervical cancer: a monocentric retrospective study
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Authors
Bernardini, Federica
Ferrandina, Gabriella
Ricci, Caterina
Fagotti, Anna
Fanfani, Francesco
Cavaliere, Anna Franca
Gui, Benedetta
Scambia, Giovanni
Vincenzo, Rosa De
Issue Date
2022-08-14
Type
Article
Language
en_US
Keywords
Cervical Cancer , Pregnancy , Neoadjuvant Chemotherapy , Cesarean Radical Hysterectomy , Tailored Treatment
Alternative Title
Abstract
Background: To date, little and discordant data still exists on the management of cervical cancer (CC) during pregnancy. In this paper, we report our experience of the treatment of these patients analyzing the oncologic, obstetric, and neonatal outcomes. Methods: Between January 2010 and December 2021, 13 patients were diagnosed with CC during pregnancy. All patients underwent platinum-based neoadjuvant chemotherapy (NACT) and 11/13 patients underwent a cesarean radical hysterectomy (CRH). Results: All 13 patients were diagnosed with squamous-cell carcinoma, FIGO-2018 stage between IB2-IIIC1. The majority of patients had a partial (61.5%) or complete (15.4%) response to NACT. Most patients had a regular course of pregnancy and the obstetric complications observed were gestational diabetes mellitus in 23.1% and IUGR in 15.4% of cases. CRH was performed in the absence of major complications. Only 2 patients (15.4%) had disease recurrence and only 1 patient (7.7%) died of disease. All children are currently healthy. At birth, we observed mainly prematurity-related complications (38.5% respiratory distress syndrome and 7.7% neonatal jaundice) and only a case of congenital malformation (hypospadias). In our pediatric population, we reported a case of malignancy (acute myeloid leukemia). Conclusion: NACT seems to be safe and efficacious in controlling tumor burden during pregnancy. CRH following NACT appears to be feasible, avoiding repeated surgery and treatment delays. This approach is also reasonably safe from a maternal, obstetric, and neonatal point of view.
Description
Citation
Bernardini, F., Ferrandina, G., Ricci, C., Fagotti, A., Fanfani, F., Cavaliere, A. F., Gui, B., Scambia, G., & De Vincenzo, R. (2022). Neoadjuvant Chemotherapy in Pregnant Patients with Cervical Cancer: A Monocentric Retrospective Study. Current oncology (Toronto, Ont.), 29(8), 5702–5714. https://doi.org/10.3390/curroncol29080450
Publisher
Current oncology (Toronto, Ont.)