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Neoadjuvant chemotherapy followed by radical hysterectomy for invasive cervical cancer diagnosed during pregnancy: report of a case and review of the literature
  1. S. Caluwaerts*,
  2. K. Van Calsteren*,
  3. L. Mertens,
  4. L. Lagae,
  5. P. Moerman§,
  6. M. Hanssens,
  7. K. Wuyts,
  8. I. Vergote* and
  9. F. Amant*
  1. *Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
  2. Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
  3. Pediatric Neurology, Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
  4. §Department of Pathology, University Hospitals Leuven, Leuven, Belgium
  5. Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
  6. Department of Obstetrics and Gynecology, H. Hart Hospital Lier, Lier, Belgium
  1. Address correspondence and reprint requests to: Frederic Amant, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. Email: frederic.amant{at}uz.kuleuven.ac.be

Abstract

Although cervical carcinoma is among the most frequently encountered malignancies during pregnancy, only four cases of neoadjuvant chemotherapy during pregnancy have been reported. A 28-year-old A0P1G2M0 was diagnosed at 15 weeks with stage Ib1 invasive squamous cervical cancer. Because she strongly desired the continuation of this pregnancy, after extensive counseling she was treated with 75 mg/m2 cisplatin every 10 days starting at 17 weeks. After six cycles, clinically and radiologically stable disease with normalization of the squamous cell carcinoma tumor marker was obtained. An elective cesarean delivery followed by radical hysterectomy and lymphadenectomy was performed at 32 weeks gestation. The pathology report revealed a moderately differentiated squamous cell carcinoma of 3.5 cm, and all 33 lymph nodes were free of disease. Neonatal examination of the baby could not reveal any abnormalities, and this was confirmed at 6 months. The use of neoadjuvant chemotherapy enabled us to continue this pregnancy until the fetus was viable. Cisplatin did not influence the short-term outcome, but only a long-term follow-up will inform us on its safety during pregnancy.

  • invasive cervical cancer
  • neoadjuvant chemotherapy
  • pregnancy

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