[Gynecological cancers and pregnancy: the point of view of the oncology gynecologist].
ABSTRACT Cervical cancer and nonepithelial ovarian cancer are the most frequent gynecological tumors diagnosed during the pregnancy. The management of patients with a malignant tumor discovered during her pregnancy depends on the type of the tumor, the tumor stage and the term of the pregnancy. In most of cases, a conservative management of the pregnancy could be offered without affect the optimal approach for the treatment of the tumor nor the survival of the patient. But such management needs to be determined in a multidisciplinary staff with oncologists, neonatologists, obstetricians but also the point of view of the patient.
- SourceAvailable from: John Tidy[show abstract] [hide abstract]
ABSTRACT: Maternal epithelial ovarian cancer (EOC) is rare, and consequently, management strategies remain unclear due to the low incidence and paucity of reported data. Management depends on gestation, disease stage, future fertility desires, and the mother's wishes to continue pregnancy. Forty-one cases of maternal EOC were identified in the literature. Reporting of clinicopathological variables, treatment regimens, and follow up varied markedly. There are currently no definitive guidelines regarding the management of maternal EOC. Case reporting should contain detailed information on clinicopathological variables, treatment regimens, and maternal and neonatal outcomes. Data centralisation may be beneficial in identifying optimal management strategies in these rare tumours.BJOG An International Journal of Obstetrics & Gynaecology 04/2009; 116(4):480-91. · 3.76 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: The aim of this study was to analyze and describe cases of ovarian cancer in pregnant women treated at our center and to review the literature concerned, and to discuss the rationale for therapy. Twenty-Three patients of ovarian malignancies during pregnancy were treated at Vali- Asr Hospital between 1991 and 2002. Data on treatment and follow-up were evaluated. The incidence of ovarian carcinoma associated with pregnancy in our series was 0.083/1000 deliveries. Eleven (47.8%) were found with ovarian malignant germ cell tumors, five (21.7%) with low malignant potential tumors, four (17.4%) with invasive epithelial tumors, and three (13%) with sex cord stromal tumors. Seventeen (73.9%) of the patients were diagnosed in stage I and had complete remission. Five of the six in advanced stage died. The mean follow-up was 36.3 months. The prognosis was significantly related with stage and histological type (P < 0.05). Sixteen healthy live babies were recorded in this group, and two premature newborn died of respiratory distress syndrome. Chemotherapy was administered to 44% of the patients, in two cases during pregnancy. Overall survival at 5 years was 61%. In most of case conservative surgical treatment could be performed with adequate staging and debulking. Early finding of ascitis by ultrasound and persistent large ovarian mass during pregnancy may be related to malignancy and advanced stage. Pregnant women in advanced stage of ovarian cancer seem to have poor prognosis.BMC Pregnancy and Childbirth 02/2008; 8:3. · 2.52 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: The management of ovarian cancer during pregnancy represents a major challenge and requires close multidisciplinary team approach. A 35-year-old pregnant woman with a yolk sac tumor underwent left salpingo-oophorectomy at 25 weeks of gestation. Chemotherapy was deferred to the end of the pregnancy owing to concerns for potential fetal risks. Alpha-feto protein level was used to monitor the underlying disease activity. The patient underwent exploratory laparotomy with cesarean section followed by total hysterectomy, omentectomy, right salpingooophorectomy, pelvic, and para-aortic lymphadenectomies at 32 weeks of gestation. She received four postoperative courses of chemotherapy (cisplatin, etoposide, and peplomycin). Currently, mother and child are doing well 6 months after the last chemotherapy cycle. In a case of yolk sac tumor in the second trimester of pregnancy, radical surgery combined with elective caesarian section followed by chemotherapy could achieve remission and rescue of fetus. However, the treatment needs to be individualized as there is lack of evidence.Archives of Gynecology 03/2009; 280(5):803-6. · 0.91 Impact Factor