Treatment patterns and outcomes in pregnancy-Associated adenocarcinoma of the Cervix

Sarah E. Taylor, Ashlee L. Smith, Thomas C. Krivak, Bunja Jane Rungruang

Research output: Contribution to journalArticle

Abstract

Objective: Cervical cancer occurs in ∼1/2200 pregnancies. Limited data exist for optimal management of cervical adenocarcinomas, which have seen a disproportionate rise in incidence. The purpose of this study was to evaluate treatment patterns and outcomes in pregnancy-Associated cervical adenocarcinoma (AC) or adenosquamous carcinoma (AS). Design: This was a retrospective observational study. Materials and Methods: Patients at a single institution diagnosed between 1990 and 2009 with cervical AC or AS during pregnancy, and within 6 weeks postpartum, were reviewed. Charts were reviewed for demographic, pathologic treatment, and outcome data. Results: Thirteen patients were identified with stage IA (2), IB (10), and IIIB (1) disease. Treatment for invasive cancer diagnosed during pregnancy included abortion followed by chemoradiation, cold knife cone (CKC) followed by cesarean radical hysterectomy, radical hysterectomy, and antenatal loop electrosurgical excision procedure (LEEP) with cesarean delivery and postpartum LEEP. Treatment for those diagnosed postpartum included chemoradiation, radical hysterectomy, simple hysterectomy, and CKC followed by radical hysterectomy. One recurrence was diagnosed 46 months after the initial surgery. Median length of follow-up was 109.75 months (range 2-229). Eleven patients are alive with no evidence of disease; two died from disease. Conclusions: Treatment patterns in this case series show good clinical outcomes, suggesting that treatment can be delayed until after delivery unless advanced stage disease is diagnosed early in pregnancy. (J GYNECOL SURG 30:5)

Original languageEnglish (US)
Pages (from-to)5-11
Number of pages7
JournalJournal of Gynecologic Surgery
Volume30
Issue number1
DOIs
Publication statusPublished - Feb 1 2014
Externally publishedYes

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ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Surgery

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