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Child development at 6 years after maternal cancer diagnosis and treatment during pregnancy
  1. C Maggen1,2,
  2. K Van Calsteren3,4,
  3. E Cardonick5,
  4. RG Shmakov6,
  5. MM Gziri7,
  6. A Cabrera Garcia8,
  7. R Fruscio9,
  8. CAR Lok10,
  9. MJ Halaska11,
  10. IA Boere12,
  11. P Zola13,
  12. PB Ottevanger14,
  13. CJM de Groot15,
  14. G Scarfone16,
  15. M Fumagalli17,
  16. RC Painter18,
  17. J de Haan15 and
  18. F Amant1,19,20
  1. 1University of Leuven, University Hospitals Leuven, Antoni van Leeuwenhoek – Netherlands Cancer Institute, KU Leuven
  2. 2Department of Obstetrics and Gynaecology, University Hospitals Leuven
  3. 3Department of Obstetrics, University Hospitals Leuven, UZ Leuven
  4. 4Department of Development and Regeneration, KU Leuven – University of Leuven, Leuven, Belgium
  5. 5Department of Obstetrics and Gynaecology, Cooper University Health Care, Camden, NJ, USA
  6. 6Federal State Budget Institution ‘Research Centre for Obstetrics, Gynaecology and Perinatology’, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
  7. 7KU Leuven – University of Leuven, University Hospitals Leuven | Antoni van Leeuwenhoek – Netherlands Cancer Institute, Cliniques Universitaires St Luc, Leuven, Belgium
  8. 8Hospital Regional de Alta Especialidad de Ixtapaluca (HRAEI), Mexico, Mexico
  9. 9Clinic of Obstetrics and Gynecology, University of Milan Bicocca, Milan, Italy
  10. 10Centre for Gynaecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
  11. 11Faculty Hospital Kralovske Vinohrady, Charles University, 3rd Medical Facculty, Prague, Czech Republic
  12. 12Medical Oncology, Erasmus MC, Rotterdam, The Netherlands
  13. 13Department of Surgical Sciences, University of Turin, Turin, Italy
  14. 14Department of Medical Oncology, Radboud UMC Nijmegen, Nijmegen
  15. 15Department of Obstetrics and Gynaecology, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands
  16. 16Gynaecological Oncology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
  17. 17Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan
  18. 18Department of Obstetrics and Gynaecology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
  19. 19Department of Gynaecological Oncology, UZ Leuven, Leuven, Belgium
  20. 20Centre of Gynaecological Oncology (CGOA), Amsterdam UMC, Location AMC, VUmc, NKI, Amsterdam, The Netherlands

Abstract

Introduction/Background The International Network of Cancer, Infertility and Pregnancy was launched in order to register women of reproductive age with a cancer diagnosis. Over the years, the project has expanded with currently 2653 cases registered by 114 centres and an annual registration rate of 150 patients. The expected rising numbers of cancer diagnosis during pregnancy as a result of an increased age at first childbirth and the possibility of early cancer detection by the non-invasive prenatal testing calls for an ongoing evaluation of clinical practice. Moreover, women might become pregnant while exposed to new target therapies that are being introduced into oncological practice.

Methodology The INCIP database consists of a secured on-line registration tool. Oncological, obstetric and neonatal data are registered by members. Annual scientific meetings give updates on the ongoing research projects.

Results Most patients were registered in Belgium, the Netherlands, Italy and USA and one third of participating centres are non-European. Currently 2059 patients with a cancer diagnosis or treatment during pregnancy are registered, 395 women that received fertility preservation and 199 patients with a postnatal cancer diagnosis (figure 1). Breast cancer, lymphoma and cervical cancer are the most frequent registered cancer types and the majority of patients (67%) received antenatal cancer treatment (figure 2). Most women delivered a live born baby (88%), however 47% delivered preterm and 80% of preterm deliveries were medically induced. One-fifth of neonates (21%) were small for gestational age. Congenital malformations were reported in 3% of live births.

Abstract – Figure 1

Registered cases by INCIP

Abstract – Figure 2

Management of cancer during pregnancy according to trimester of diagnosis

Conclusion Cancer occurring in women endangers obstetrical and neonatal outcome and potentially future fertility. The INCIP registry is open for further collection of data since for such a relatively rare situation, only a large scale project will provide better insights on maternal and foetal risks assessment, which is essential for optimal patient counselling and care.

Disclosure The INCIP network would not be able to operate without the ongoing support of ESGO. Furthermore the project is supported by the Research Foundation—Flanders (FWO) in Belgium (grant no G070514N) and the European Union’s Horizon 2020 research and innovation program under grant agreement No 647047. There are no conflicting interests to declare.

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