Best Practice & Research Clinical Obstetrics & Gynaecology
Volume 24, Issue 1 , Pages 61-79 , February 2010

Gynaecologic cancer complicating pregnancy: An overview

  • Frédéric Amant, MD, PhD (Professor Gynaecological Oncology)

      Affiliations

    • Obstetrics and Gynaecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium
    • Corresponding Author InformationCorresponding author. Tel.: +32 16 34 42 52; Fax: +32 16 34 46 29.
    • ,
  • Lieselot Brepoels, MD, PhD (Trainee Nuclear Medicine)

      Affiliations

    • Nuclear Medicine, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium
    • ,
  • Michael J. Halaska, MD, PhD (Gynaecological Oncologist)

      Affiliations

    • Obstetrics and Gynaecology, Charles University in Prague, 2nd Medical Faculty, Czech Republic
    • ,
  • Mina Mhallem Gziri, MD (Gynaecologist)

      Affiliations

    • Obstetrics and Gynaecology, Université Catholique de Louvain, Belgium
    • ,
  • Kristel Van Calsteren, MD (Research Fellow Gynaecological Oncology)

      Affiliations

    • Obstetrics and Gynaecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium

References 

  1. Cardonick E, Iacobucci A. Use of chemotherapy during human pregnancy. Lancet Oncol. 2004;5:283–291
  2. Kal HB, Struikmans H. Radiotherapy during pregnancy: fact and fiction. Lancet Oncol. 2005;6:328–333
  3. Stensheim H, Moller B, van Dijk T, et al. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol. 2009;27:45–51
  4. Pavlidis NA. Coexistence of pregnancy and malignancy. Oncologist. 2002;7:279–287
  5. Pereg D, Koren G, Lishner M. Cancer in pregnancy: gaps, challenges and solutions. Cancer Treat Rev. 2008;34:302–312
  6. Bergonie J, Tribondeau L. De quelques resultants de la radiotherapy, et esaie de fixation d'une technique rationelle. Comptes Rendu des Seances de l'Academie des Sciences. 1906;143:983–985
  7. Ratnapalan S, Bona N, Chandra K, et al. Physicians' perceptions of teratogenic risk associated with radiography and CT during early pregnancy. AJR Am J Roentgenol. 2004;182:1107–1109
  8. Damilakis J. Pregnancy and diagnostic X-rays. Eur Radiol Syllabus. 2004;14:33–39
  9. Available at www.icrp.org
  10. Stabin M, Watson E, Cristy M, et al. Mathematical models and specific absorbed fractions of photon energy in the non-pregnant adult female and at the end of each trimester of pregnancy. Report ORNL/TM-12907 Oak Ridge, TN: Oak Ridge National Laboratory; 1995;
  11. Russell JR, Stabin MG, Sparks RB, et al. Radiation absorbed dose to the embryo/fetus from radiopharmaceuticals. Health Phys. 1997;73:756–769
  12. Nuclear medicine resources manual. Vienna: International Atomic Energy Agency; 2006;STI/PUB/1198 ISBN 92-0-107504-9
  13. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000;41:863–873
  14. Available at: http://rpop.iaea.org/RPOP/RPoP/Content/SpecialGroups/1_PregnantWomen/index.htm
  15. Nagayama M, Watanabe Y, Okumura A, et al. Fast MR imaging in obstetrics. Radiographics. 2002;22:563–580
  16. Stubbe P, Heidemann P, Schurnbrand P, et al. Transient congenital hypothyroidism after amniofetography. Eur J Pediatr. 1980;135:97–99
  17. Webb JA, Thomsen HS, Morcos SK. The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol. 2005;15:1234–1240
  18. Woo SY, Fuller LM, Cundiff JH, et al. Radiotherapy during pregnancy for clinical stages IA-IIA Hodgkin's disease. Int J Radiat Oncol Biol Phys. 1992;23:407–412
  19. Stovall M, Blackwell CR, Cundiff J, et al. Fetal dose from radiotherapy with photon beams: report of AAPM Radiation Therapy Committee Task Group No. 36. Med Phys. 1995;22:63–82
  20. Ni Mhuireachtaigh R, O'Gorman DA. Anesthesia in pregnant patients for nonobstetric surgery. J Clin Anesth. 2006;18:60–66
  21. Moran BJ, Yano H, Al Zahir N, et al. Conflicting priorities in surgical intervention for cancer in pregnancy. Lancet Oncol. 2007;8:536–544
  22. Cohen-Kerem R, Railton C, Oren D, et al. Pregnancy outcome following non-obstetric surgical intervention. Am J Surg. 2005;190:467–473
  23. Jackson H, Granger S, Price R, et al. Diagnosis and laparoscopic treatment of surgical diseases during pregnancy: an evidence-based review. Surg Endosc. 2008;22:1917–1927
  24. Rizzo AG. Laparoscopic surgery in pregnancy: long-term follow-up. J Laparoendosc Adv Surg Tech A. 2003;13:11–15
  25. Mathevet P, Nessah K, Dargent D, et al. Laparoscopic management of adnexal masses in pregnancy: a case series. Eur J Obstet Gynecol Reprod Biol. 2003;108:217–222
  26. Yuen PM, Ng PS, Leung PL, et al. Outcome in laparoscopic management of persistent adnexal mass during the second trimester of pregnancy. Surg Endosc. 2004;18:1354–1357
  27. Affleck DG, Handrahan DL, Egger MJ, et al. The laparoscopic management of appendicitis and cholelithiasis during pregnancy. Am J Surg. 1999;178:523–529
  28. Peccatori F, Martinelli G, Gentilini O, et al. Chemotherapy during pregnancy: what is really safe?. Lancet Oncol. 2004;5:398
  29. Reynoso EE, Huerta F. Acute leukemia and pregnancy–fatal fetal outcome after exposure to idarubicin during the second trimester. Acta Oncol. 1994;33:709–710
  30. Bakri YN, Given FT. Normal pregnancy and delivery following conservative surgery and chemotherapy for ovarian endodermal sinus tumor. Gynecol Oncol. 1984;19:222–225
  31. Caluwaerts S, Van Calsteren K, Mertens L, et al. Neoadjuvant chemotherapy followed by radical hysterectomy for invasive cervical cancer diagnosed during pregnancy: report of a case and review of the literature. Int J Gynecol Cancer. 2006;16:905–908
  32. Elit L, Bocking A, Kenyon C, et al. An endodermal sinus tumor diagnosed in pregnancy: case report and review of the literature. Gynecol Oncol. 1999;72:123–127
  33. Ferrandina G, Distefano M, Testa A, et al. Management of an advanced ovarian cancer at 15 weeks of gestation: case report and literature review. Gynecol Oncol. 2005;97:693–696
  34. Garrido M, Clavero J, Huete A, et al. Prolonged survival of a woman with lung cancer diagnosed and treated with chemotherapy during pregnancy. Review of cases reported. Lung Cancer. 2008;60:285–290
  35. Han JY, Nava-Ocampo AA, Kim TJ, et al. Pregnancy outcome after prenatal exposure to bleomycin, etoposide and cisplatin for malignant ovarian germ cell tumors: report of 2 cases. Reprod Toxicol. 2005;19:557–561
  36. Horbelt D, Delmore J, Meisel R, et al. Mixed germ cell malignancy of the ovary concurrent with pregnancy. Obstet Gynecol. 1994;84:662–664
  37. Karimi ZM, Behtash N, Modares GM. Good pregnancy outcome after prenatal exposure to bleomycin, etoposide and cisplatin for ovarian immature teratoma: a case report and literature review. Arch Gynecol Obstet. 2008;277:75–78
  38. Kim DS, Park MI. Maternal and fetal survival following surgery and chemotherapy of endodermal sinus tumor of the ovary during pregnancy: a case report. Obstet Gynecol. 1989;73:503–507
  39. Kim JH, Kim HS, Sung CW, et al. Docetaxel, gemcitabine, and cisplatin administered for non-small cell lung cancer during the first and second trimester of an unrecognized pregnancy. Lung Cancer. 2008;59:270–273
  40. Machado F, Vegas C, Leon J, et al. Ovarian cancer during pregnancy: analysis of 15 cases. Gynecol Oncol. 2007;105:446–450
  41. Malhotra N, Sood M. Endodermal sinus tumor in pregnancy. Gynecol Oncol. 2000;78:265–266
  42. Otton G, Higgins S, Phillips KA, et al. A case of early-stage epithelial ovarian cancer in pregnancy. Int J Gynecol Cancer. 2001;11:413–417
  43. Palaia I, Pernice M, Graziano M, et al. Neoadjuvant chemotherapy plus radical surgery in locally advanced cervical cancer during pregnancy: a case report. Am J Obstet Gynecol. 2007;197:e5–e6
  44. Raffles A, Williams J, Costeloe K, et al. Transplacental effects of maternal cancer chemotherapy. Case report. Br J Obstet Gynaecol. 1989;96:1099–1100
  45. Robova H, Rob L, Hrehorcak M, et al. Endodermal sinus tumor diagnosed in pregnancy: a case report. Int J Gynecol Cancer. 2007;17:914–916
  46. Sood AK, Shahin MS, Sorosky JI. Paclitaxel and platinum chemotherapy for ovarian carcinoma during pregnancy. Gynecol Oncol. 2001;83:599–600
  47. Henderson CE, Elia G, Garfinkel D, et al. Platinum chemotherapy during pregnancy for serous cystadenocarcinoma of the ovary. Gynecol Oncol. 1993;49:92–94
  48. Picone O, Lhomme C, Tournaire M, et al. Preservation of pregnancy in a patient with a stage IIIB ovarian epithelial carcinoma diagnosed at 22 weeks of gestation and treated with initial chemotherapy: case report and literature review. Gynecol Oncol. 2004;94:600–604
  49. Bader AA, Schlembach D, Tamussino KF, et al. Anhydramnios associated with administration of trastuzumab and paclitaxel for metastatic breast cancer during pregnancy. Lancet Oncol. 2007;8:79–81
  50. Gadducci A, Cosio S, Fanucchi A, et al. Chemotherapy with epirubicin and paclitaxel for breast cancer during pregnancy: case report and review of the literature. Anticancer Res. 2003;23:5225–5229
  51. Gonzalez-Angulo AM, Walters RS, Carpenter RJ, et al. Paclitaxel chemotherapy in a pregnant patient with bilateral breast cancer. Clin Breast Cancer. 2004;5:317–319
  52. Hubalek M, Smekal-Schindelwig C, Zeimet AG, et al. Chemotherapeutic treatment of a pregnant patient with ovarian dysgerminoma. Arch Gynecol Obstet. 2007;276:179–183
  53. Lycette JL, Dul CL, Munar M, et al. Effect of pregnancy on the pharmacokinetics of paclitaxel: a case report. Clin Breast Cancer. 2006;7:342–344
  54. Mantovani G, Gramignano G, Mais V, et al. Use of chemotherapy for ovarian cancer during human pregnancy: case report and literature review. Eur J Obstet Gynecol Reprod Biol. 2007;131:238–239
  55. Mendez LE, Mueller A, Salom E, et al. Paclitaxel and carboplatin chemotherapy administered during pregnancy for advanced epithelial ovarian cancer. Obstet Gynecol. 2003;102:1200–1202
  56. Modares GM, Karimi ZM, Behtash N, et al. Preservation of pregnancy in a patient with advanced ovarian cancer at 20 weeks of gestation: case report and literature review. Int J Gynecol Cancer. 2007;17:1140–1143
  57. Garcia MM, Lopez GG, Pina IL, et al. [Breast cancer during pregnancy], Rev Med Univ Navarra. 2008;52:18–24
  58. Garcia-Gonzalez J, Cueva J, Lamas MJ, et al. Paclitaxel and cisplatin in the treatment of metastatic non-small-cell lung cancer during pregnancy. Clin Transl Oncol. 2008;10:375–376
  59. De Santis M, Lucchese A, De Carolis S, et al. Metastatic breast cancer in pregnancy: first case of chemotherapy with docetaxel. Eur J Cancer Care. 2000;9:235–237
  60. Gainford MC, Clemons M. Breast cancer in pregnancy: are taxanes safe?. Clin Oncol. 2006;18:159
  61. Nieto Y, Santisteban M, Aramendia JM, et al. Docetaxel administered during pregnancy for inflammatory breast carcinoma. Clin Breast Cancer. 2006;6:533–534
  62. Potluri V, Lewis D, Burton GV. Chemotherapy with taxanes in breast cancer during pregnancy: case report and review of the literature. Clin Breast Cancer. 2006;7:167–170
  63. Sekar R, Stone PR. Trastuzumab use for metastatic breast cancer in pregnancy. Obstet Gynecol. 2007;110:507–510
  64. Motegi M, Takakura S, Takano H, et al. Adjuvant chemotherapy in a pregnant woman with endodermal sinus tumor of the ovary. Obstet Gynecol. 2007;109:537–540
  65. Mir O, Berveiller P, Ropert S, et al. Emerging therapeutic options for breast cancer chemotherapy during pregnancy. Ann Oncol. 2008;19:607–613
  66. Pant S, Landon MB, Blumenfeld M, et al. Treatment of breast cancer with trastuzumab during pregnancy. J Clin Oncol. 2008;26:1567–1569
  67. Watson WJ. Herceptin (trastuzumab) therapy during pregnancy: association with reversible anhydramnios. Obstet Gynecol. 2005;105:642–643
  68. Shrim A, Garcia-Bournissen F, Maxwell C, et al. Favorable pregnancy outcome following Trastuzumab (Herceptin) use during pregnancy–case report and updated literature review. Reprod Toxicol. 2007;23:611–613
  69. Fanale MA, Uyei AR, Theriault RL, et al. Treatment of metastatic breast cancer with trastuzumab and vinorelbine during pregnancy. Clin Breast Cancer. 2005;6:354–356
  70. Waterston AM, Graham J. Effect of adjuvant trastuzumab on pregnancy. J Clin Oncol. 2006;24:321–322
  71. Witzel ID, Muller V, Harps E, et al. Trastuzumab in pregnancy associated with poor fetal outcome. Ann Oncol. 2008;19:191–192
  72. Paskulin GA, Gazzola Zen PR, Camargo Pinto LL, et al. Combined chemotherapy and teratogenicity. Birth Defects Res A Clin Mol Teratol. 2005;73:634–637
  73. Ring AE, Smith IE, Jones A, et al. Chemotherapy for breast cancer during pregnancy: an 18-year experience from five London teaching hospitals. J Clin Oncol. 2005;23:4192–4197
  74. Chelghoum Y, Vey N, Raffoux E, et al. Acute leukemia during pregnancy: a report on 37 patients and a review of the literature. Cancer. 2005;104:110–117
  75. Hahn KM, Johnson PH, Gordon N, et al. Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer. 2006;107:1219–1226
  76. Aviles A, Neri N. Hematological malignancies and pregnancy: a final report of 84 children who received chemotherapy in utero. Clin Lymphoma. 2001;2:173–177
  77. Zemlickis D, Lishner M, Erlich R, et al. Teratogenicity and carcinogenicity in a twin exposed in utero to cyclophosphamide. Teratog Carcinog Mutagen. 1993;13:139–143
  78. Van Calsteren K, Berteloot P, Hanssens M, et al. In utero exposure to chemotherapy: effect on cardiac and neurologic outcome. J Clin Oncol. 2006;24:e16–e17
  79. Aviles A, Neri N, Nambo MJ. Long-term evaluation of cardiac function in children who received anthracyclines during pregnancy. Ann Oncol. 2006;17:286–288
  80. Siu BL, Alonzo MR, Vargo TA, et al. Transient dilated cardiomyopathy in a newborn exposed to idarubicin and all-trans-retinoic acid (ATRA) early in the second trimester of pregnancy. Int J Gynecol Cancer. 2002;12:399–402
  81. Achtari C, Hohlfeld P. Cardiotoxic transplacental effect of idarubicin administered during the second trimester of pregnancy. Am J Obstet Gynecol. 2000;183:511–512
  82. Matsuo K, Shimoya K, Ueda S, et al. Idarubicin administered during pregnancy: its effects on the fetus. Gynecol Obstet Invest. 2004;58:186–188
  83. Johnson S. Cognitive and behavioural outcomes following very preterm birth. Semin Fetal Neonatal Med. 2007;12:363–373
  84. Pentheroudakis G, Pavlidis N. Cancer and pregnancy: poena magna, not anymore. Eur J Cancer. 2006;42:126–140
  85. Jacobs IA, Chang CK, Salti GI. Coexistence of pregnancy and cancer. Am Surg. 2004;70:1025–1029
  86. Bonnier P, Romain S, Dilhuydy JM, et al. Influence of pregnancy on the outcome of breast cancer: a case-control study. Societe Francaise de Senologie et de Pathologie Mammaire Study Group. Int J Cancer. 1997;72:720–727
  87. Chang YT, Loong CC, Wang HC, et al. Breast cancer and pregnancy. Zhonghua Yi Xue Za Zhi (Taipei). 1994;54:223–229
  88. Ibrahim EM, Ezzat AA, Baloush A, et al. Pregnancy-associated breast cancer: a case-control study in a young population with a high-fertility rate. Med Oncol. 2000;17:293–300
  89. Ishida T, Yokoe T, Kasumi F, et al. Clinicopathologic characteristics and prognosis of breast cancer patients associated with pregnancy and lactation: analysis of case-control study in Japan. Jpn J Cancer Res. 1992;83:1143–1149
  90. Lethaby AE, O'Neill MA, Mason BH, et al. Overall survival from breast cancer in women pregnant or lactating at or after diagnosis. Auckland Breast Cancer Study Group. Int J Cancer. 1996;67:751–755
  91. Nugent P, O'Connell TX. Breast cancer and pregnancy. Arch Surg. 1985;120:1221–1224
  92. Petrek JA, Dukoff R, Rogatko A. Prognosis of pregnancy-associated breast cancer. Cancer. 1991;67:869–872
  93. Zemlickis D, Lishner M, Degendorfer P, et al. Maternal and fetal outcome after breast cancer in pregnancy. Am J Obstet Gynecol. 1992;166:781–787
  94. Zhang J, Liu G, Wu J, et al. Pregnancy-associated breast cancer: a case control and long-term follow-up study in China. J Exp Clin Cancer Res. 2003;22:23–27
  95. Halaska MJ, Pentheroudakis G, Strnad P, et al. Presentation, management and outcome of 32 patients with pregnancy-associated breast cancer: a matched controlled study. Breast J. 2009;15:461–467
  96. Kahlert S, Bauerfeind I, Strauss A, et al. [Breast cancer treatment during pregnancy - experiences in the department of OB/GYN Grosshadern-Munich and review of international data], Zentralbl Gynakol. 2004;126:159–166
  97. Hunter MI, Monk BJ, Tewari KS. Cervical neoplasia in pregnancy. Part 1: screening and management of preinvasive disease. Am J Obstet Gynecol. 2008;199:3–9
  98. Economos K, Perez VN, Delke I, et al. Abnormal cervical cytology in pregnancy: a 17-year experience. Obstet Gynecol. 1993;81:915–918
  99. Robova H, Rob L, Pluta M, et al. Squamous intraepithelial lesion-microinvasive carcinoma of the cervix during pregnancy. Eur J Gynaecol Oncol. 2005;26:611–614
  100. Van Calsteren K, Vergote I, Amant F. Cervical neoplasia during pregnancy: diagnosis, management and prognosis. Best Pract Res Clin Obstet Gynaecol. 2005;19:611–630
  101. Yost NP, Santoso JT, McIntire DD, et al. Postpartum regression rates of antepartum cervical intraepithelial neoplasia II and III lesions. Obstet Gynecol. 1999;93:359–362
  102. Serati M, Uccella S, Laterza RM, et al. Natural history of cervical intraepithelial neoplasia during pregnancy. Acta Obstet Gynecol Scand. 2008;87:1296–1300
  103. Siristatidis C, Vitoratos N, Michailidis E, et al. The role of the mode of delivery in the alteration of intrapartum pathological cervical cytologic findings during the postpartum period. Eur J Gynaecol Oncol. 2002;23:358–360
  104. Robinson WR, Webb S, Tirpack J, et al. Management of cervical intraepithelial neoplasia during pregnancy with LOOP excision. Gynecol Oncol. 1997;64:153–155
  105. Takushi M, Moromizato H, Sakumoto K, et al. Management of invasive carcinoma of the uterine cervix associated with pregnancy: outcome of intentional delay in treatment. Gynecol Oncol. 2002;87:185–189
  106. Lee RB, Neglia W, Park RC. Cervical carcinoma in pregnancy. Obstet Gynecol. 1981;58:584–589
  107. Sood AK, Sorosky JI, Krogman S, et al. Surgical management of cervical cancer complicating pregnancy: a case-control study. Gynecol Oncol. 1996;63:294–298
  108. Choi HJ, Roh JW, Seo SS, et al. Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma: a prospective study. Cancer. 2006;106:914–922
  109. Fischerova D, Cibula D, Stenhova H, et al. Transrectal ultrasound and magnetic resonance imaging in staging of early cervical cancer. Int J Gynecol Cancer. 2008;18:766–772
  110. Prem KA, Makowski EL, McKelvey JL. Carcinoma of the cervix associated with pregnancy. Am J Obstet Gynecol. 1966;95:99–108
  111. Sood AK, Sorosky JI, Mayr N, et al. Radiotherapeutic management of cervical carcinoma that complicates pregnancy. Cancer. 1997;80:1073–1078
  112. Gao JZ. [Carcinoma of the uterine cervix associated with pregnancy–analysis of 458 cases], Zhonghua Zhong Liu Za Zhi. 1985;7:366–369
  113. Saunders N, Landon CR. Management problems associated with carcinoma of the cervix diagnosed in the second trimester of pregnancy. Gynecol Oncol. 1988;30:120–122
  114. Wyatt RM, Beddoe AH, Dale RG. The effects of delays in radiotherapy treatment on tumour control. Phys Med Biol. 2003;48:139–155
  115. Coles CE, Burgess L, Tan LT. An audit of delays before and during radical radiotherapy for cervical cancer–effect on tumour cure probability. Clin Oncol (R Coll Radiol). 2003;15:47–54
  116. Hunter MI, Tewari K, Monk BJ. Cervical neoplasia in pregnancy. Part 2: current treatment of invasive disease. Am J Obstet Gynecol. 2008;199:10–18
  117. Ben Arie A, Levy R, Lavie O, et al. Conservative treatment of stage IA2 squamous cell carcinoma of the cervix during pregnancy. Obstet Gynecol. 2004;104:1129–1131
  118. Van Calsteren K, Hanssens M, Moerman P, et al. Successful conservative treatment of endocervical adenocarcinoma stage Ib1 diagnosed early in pregnancy. Acta Obstet Gynecol Scand. 2008;87:250–253
  119. van de Nieuwenhof HP, van Ham MA, Lotgering FK, et al. First case of vaginal radical trachelectomy in a pregnant patient. Int J Gynecol Cancer. 2008;18:1381–1385
  120. Ungar L, Smith JR, Palfalvi L, et al. Abdominal radical trachelectomy during pregnancy to preserve pregnancy and fertility. Obstet Gynecol. 2006;108:811–814
  121. Monk BJ, Montz FJ. Invasive cervical cancer complicating intrauterine pregnancy: treatment with radical hysterectomy. Obstet Gynecol. 1992;80:199–203
  122. Safar P, Uhlir M, Janousek M, et al. [Cervical carcinoma during pregnancy], Ceska Gynekol. 2000;65:50–52
  123. Sivanesaratnam V, Jayalakshmi P, Loo C. Surgical management of early invasive cancer of the cervix associated with pregnancy. Gynecol Oncol. 1993;48:68–75
  124. van Vliet W, van Loon AJ, ten Hoor KA, et al. Cervical carcinoma during pregnancy: outcome of planned delay in treatment. Eur J Obstet Gynecol Reprod Biol. 1998;79:153–157
  125. Robova H, Pluta M, Hrehorcak M, et al. High-dose density chemotherapy followed by simple trachelectomy: full-term pregnancy. Int J Gynecol Cancer. 2008;18:1367–1371
  126. Plante M, Lau S, Brydon L, et al. Neoadjuvant chemotherapy followed by vaginal radical trachelectomy in bulky stage IB1 cervical cancer: case report. Gynecol Oncol. 2006;101:367–370
  127. Bader AA, Petru E, Winter R. Long-term follow-up after neoadjuvant chemotherapy for high-risk cervical cancer during pregnancy. Gynecol Oncol. 2007;105:269–272
  128. Benhaim Y, Pautier P, Bensaid C, et al. Neoadjuvant chemotherapy for advanced stage cervical cancer in a pregnant patient: report of one case with rapid tumor progression. Eur J Obstet Gynecol Reprod Biol. 2008;136:267–268
  129. Giacalone PL, Laffargue F, Benos P, et al. Cis-platinum neoadjuvant chemotherapy in a pregnant woman with invasive carcinoma of the uterine cervix. Br J Obstet Gynaecol. 1996;103:932–934
  130. Karam A, Feldman N, Holschneider CH. Neoadjuvant cisplatin and radical cesarean hysterectomy for cervical cancer in pregnancy. Nat Clin Pract Oncol. 2007;4:375–380
  131. Marana HR, de Andrade JM, Silva Mathes AC, et al. Chemotherapy in the treatment of locally advanced cervical cancer and pregnancy. Gynecol Oncol. 2001;80:272–274
  132. Tewari K, Cappuccini F, Gambino A, et al. Neoadjuvant chemotherapy in the treatment of locally advanced cervical carcinoma in pregnancy: a report of two cases and review of issues specific to the management of cervical carcinoma in pregnancy including planned delay of therapy. Cancer. 1998;82:1529–1534
  133. Madeleine MM, Daling JR, Carter JJ, et al. Cofactors with human papillomavirus in a population-based study of vulvar cancer. J Natl Cancer Inst. 1997;89:1516–1523
  134. Stroup AM, Harlan LC, Trimble EL. Demographic, clinical, and treatment trends among women diagnosed with vulvar cancer in the United States. Gynecol Oncol. 2008;108:577–583
  135. Maw RD. Treatment of external genital warts with 5% imiquimod cream during pregnancy: a case report. BJOG. 2004;111:1475
  136. Latimer J. Gynaecological malignancies in pregnancy. Curr Opin Obstet Gynecol. 2007;19:140–144
  137. Keskin N, Iyibozkurt AC, Topuz S, et al. Invasive squamous carcinoma of the vulva in women aged less than 40 years: report of two cases and a third case diagnosed during pregnancy. Eur J Gynaecol Oncol. 2008;29:399–401
  138. Bakour SH, Jaleel H, Weaver JB, et al. Vulvar carcinoma presenting during pregnancy, associated with recurrent bone marrow hypoplasia: a case report and literature review. Gynecol Oncol. 2002;87:207–209
  139. Ogunleye D, Lewin SN, Huettner P, et al. Recurrent vulvar carcinoma in pregnancy. Gynecol Oncol. 2004;95:400–401
  140. Vaccarello L, Apte SM, Copeland LJ, et al. Endometrial carcinoma associated with pregnancy: A report of three cases and review of the literature. Gynecol Oncol. 1999;74:118–122
  141. Schammel DP, Mittal KR, Kaplan K, et al. Endometrial adenocarcinoma associated with intrauterine pregnancy. A report of five cases and a review of the literature. Int J Gynecol Pathol. 1998;17:327–335
  142. Ayhan A, Gunalp S, Karaer C, et al. Endometrial adenocarcinoma in pregnancy. Gynecol Oncol. 1999;75:298–299
  143. Foersterling DL, Blythe JG. Ovarian carcinoma, endometrial carcinoma, and pregnancy. Gynecol Oncol. 1999;72:425–426
  144. Ichikawa Y, Takano K, Higa S, et al. Endometrial carcinoma coexisting with pregnancy, presumed to derive from adenomyosis: a case report. Int J Gynecol Cancer. 2001;11:488–490
  145. Itoh K, Shiozawa T, Shiohara S, et al. Endometrial carcinoma in septate uterus detected 6 months after full-term delivery: case report and review of the literature. Gynecol Oncol. 2004;93:242–247
  146. Wall JA, Lucci JA. Adenocarcinoma of the corpus uteri and pelvic tuberculosis complicating pregnancy; report of case with delivery of live infant and successful recovery. Obstet Gynecol. 1953;2:629–635
  147. Bernhard LM, Klebba PK, Gray DL, et al. Predictors of persistence of adnexal masses in pregnancy. Obstet Gynecol. 1999;93:585–589
  148. Giuntoli RL, Vang RS, Bristow RE. Evaluation and management of adnexal masses during pregnancy. Clin Obstet Gynecol. 2006;49:492–505
  149. Oehler MK, Wain GV, Brand A. Gynaecological malignancies in pregnancy: a review. Aust N Z J Obstet Gynaecol. 2003;43:414–420
  150. Karlan BY, Marrs R, Lagasse LD. Advanced-stage ovarian carcinoma presenting during infertility evaluation. Am J Obstet Gynecol. 1994;171:1377–1378
  151. Murdoch WJ. Ovarian surface epithelium, ovulation and carcinogenesis. Biol Rev Camb Philos Soc. 1996;71:529–543
  152. Takeuchi T, Suzuki S, Hayashi Z, et al. Primary ovarian tumor undergoing surgical management during pregnancy. J Nippon Med Sch. 2002;69:39–42
  153. Martinez-Onsurbe P, Ruiz VA, Sanz Anquela JM, et al. Aspiration cytology of 147 adnexal cysts with histologic correlation. Acta Cytol. 2001;45:941–947
  154. Guariglia L, Conte M, Are P, et al. Ultrasound-guided fine needle aspiration of ovarian cysts during pregnancy. Eur J Obstet Gynecol Reprod Biol. 1999;82:5–9
  155. Milad MP, Olson E. Factors that increase the risk of leakage during surgical removal of benign cystic teratomas. Hum Reprod. 1999;14:2264–2267
  156. Whitecar MP, Turner S, Higby MK. Adnexal masses in pregnancy: a review of 130 cases undergoing surgical management. Am J Obstet Gynecol. 1999;181:19–24
  157. Tewari K, Brewer C, Cappuccini F, et al. Advanced-stage small cell carcinoma of the ovary in pregnancy: long-term survival after surgical debulking and multiagent chemotherapy. Gynecol Oncol. 1997;66:531–534
  158. Zhao XY, Huang HF, Lian LJ, et al. Ovarian cancer in pregnancy: a clinicopathologic analysis of 22 cases and review of the literature. Int J Gynecol Cancer. 2006;16:8–15
  159. Ishioka S, Hayashi T, Endo T, et al. Advanced epithelial ovarian carcinoma during pregnancy. Int J Clin Oncol. 2007;12:375–378
  160. Behtash N, Karimi ZM, Modares GM, et al. Ovarian carcinoma associated with pregnancy: a clinicopathologic analysis of 23 cases and review of the literature. BMC Pregnancy Childbirth. 2008;8:3
  161. Tabata T, Nishiura K, Tanida K, et al. Carboplatin chemotherapy in a pregnant patient with undifferentiated ovarian carcinoma: case report and review of the literature. Int J Gynecol Cancer. 2008;18:181–184
  162. Malfetano JH, Goldkrand JW. Cis-platinum combination chemotherapy during pregnancy for advanced epithelial ovarian carcinoma. Obstet Gynecol. 1990;75:545–547
  163. Sankaranarayanan R, Ferlay J. Worldwide burden of gynaecological cancer: the size of the problem. Best Pract Res Clin Obstet Gynaecol. 2006;20:207–225
  164. Van Calsteren K, Heyns L, De Smet F et al. Cancer during pregnancy: an analysis of 215 patients emphasising the obstetrical and neonatal outcome. J Clin Oncol, in press.

☆ Frédéric Amant is clinical researcher for F.W.O.; Kristel Van Calsteren is aspirant for F.W.O.; This work is supported by F.W.O. Project G. 0358.06, ‘Stichting tegen kanker Project SCIE2006-17’, Research Fund K.U.Leuven.

PII: S1521-6934(09)00102-3

doi: 10.1016/j.bpobgyn.2009.08.001

Best Practice & Research Clinical Obstetrics & Gynaecology
Volume 24, Issue 1 , Pages 61-79 , February 2010

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