Individual management of cervical cancer in pregnancy

• Thomas Hecking
• Alina Abramian
• Christian Domröse
• Tabea Engeln
• Thore Thiesler
• Claudia Leutner
• Ulrich Gembruch
• Mignon-Denise Keyver-Paik
• Walther Kuhn
• Kirsten Kübler

Abstract

Purpose. The management of cervical cancer in pregnancy persists to be challenging. Therefore, identification of factors that influence the choice of therapeutic management is pivotal for an adequate patient counseling.

Methods. We present a literature review of 26 studies reporting 121 pregnancies affected by cervical cancer. Additionally, we add a retrospective case series of five patients with pregnancy-associated cervical cancer diagnosed and treated in our clinic between 2006 and 2013.

Results. The literature review revealed that the therapeutic management during pregnancy varies according to the gestational age at diagnosis, while in the postpartum period no influence on the treatment choice could be detected. Also in our case series the choice of oncologic therapy was influenced by the gestational age, the wish to continue the pregnancy and the risks of delaying definitive treatment.

Conclusions. There are no standardized procedures concerning the treatment of cervical cancer in pregnancy. Therefore, in consultation with the patient and a multidisciplinary team, an adequate individualized treatment plan should be determined.

Keywords:cervical cancer, pregnancy, treatment, chemotherapy, review, case series

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