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309 Neo-adjuvant chemotherapy for cervical cancer during pregnancy: a retrospective case series
  1. A Lopez1,
  2. J Rodríguez2,
  3. E Estrada3,
  4. C Chavez1,
  5. C Amaro4,
  6. A Aragona5,
  7. C De Padua6,
  8. A Borges Garnica7,
  9. G Rendón8,
  10. A Almeciga9,
  11. O Serrano10,
  12. S Scasso11,
  13. J Laufer11,
  14. D Greif11,
  15. F Taranto12,
  16. A Mora13 and
  17. R Pareja14
  1. 1Department of Gynecologic surgery. Instituto Nacional de Enfermedades Neoplásicas, Peru
  2. 2Department of Gynecology Oncology. Instituto Nacional de Cancerología. Department of Gynecology and obstetrics. Section of Gynecology Oncology. Fundación Santa Fe de Bogotá, Colombia
  3. 3Hospital General San Juan de Dios, Guatemala
  4. 4Hospital Cayetano Heredia, Peru
  5. 5Hospital Municipal de Oncología Marie Curie, Argentina
  6. 6Hospital de Câncer de Barretos – Fundação Pio XII, Brazil
  7. 7Unidad de Terapia Antineoplásica (UTAN).Centro Médico Guerra Méndez, Venezuela
  8. 8Department of Gynecologic Oncology. Instituto de Cancerología- Las Américas-Auna. Hospital General, Colombia
  9. 9Department of Gynecology Oncology. Instituto Nacional de Cancerología, Colombia
  10. 10Department of Gynecologic Oncology. Hospital Militar Central de Bogotá, Colombia
  11. 11Department of Gynecologic Oncology. Hospital Pereira Rossell, Uruguay
  12. 12Department of Gynecology. Hospital de Clínicas Dr. Manuel Quintela. Universidad de la República, Uruguay
  13. 13Department of Gynecology Oncology. Hospital México, Costa Rica
  14. 14Clínica de Oncología Astorga. Universidad Pontificia Bolivariana. Department of Gynecology Oncology. Instituto Nacional de Cancerología, Colombia


Introduction Neo-adjuvant chemotherapy (NACT) in cervical cancer during pregnancy may help in disease control while fetal maturity is reached, before providing a definitive oncological treatment. The objective of this study is to describe obstetric and oncological outcomes in patients diagnosed with cervical cancer stage IB1-IVA (FIGO 2009) during pregnancy, who received this treatment approach.

Methods A multicenter retrospective review was conducted in 12 institutions from 7 Latin-American countries, between January 2007 and December 2018. Data collected included clinical characteristics, NACT agents, definitive treatment, obstetric and oncologic outcomes.

Results Twenty-nine patients were included. Mean age was 33.8 years (+5.2). Twelve (41.4%) women were diagnosed at early stage, and 17 (58.6%) in locally advanced stage. Carboplatin/Paclitaxel was the most frequent combination used (55.2%). Median number of cycles was 3 (1–6). Median gestational age at delivery was 35 (30–39) weeks. All the women delivered by caesarean section and had live births. Two (6.9%) neonates presented low birth weight. There was no evidence of acute toxicity due to chemotherapy. Oncological definitive treatment was chemo-radiotherapy in 15 (51.7%) cases, radical hysterectomy in 12 (41.4%), and just chemotherapy in 2 (6.9%). After a median follow up of 15.6 months (1.8–82.2), three (10.3%) patients recurred, three (10.3%) progressed during treatment, and four (13.8%) died due to disease.

Conclusion NACT during pregnancy is an alternative approach to offer to cervical cancer patients, in order to achieve fetal maturity, before giving definitive treatment; obstetrical and neonatal outcomes were favorable. Oncological outcome deserves further investigation.

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