Cancer and pregnancy: Six years of experience in a cancer reference centre in a Latin-American country (2007-2013)
Keywords:
Pregnancy, Neoplasms, Case reportsAbstract
Objective: To describe the socio-demographic, epidemiological, clinical and pathological characteristics, as well as the treatment and complications of patients diagnosed with cancer who became pregnant and those that were diagnosed with cancer when pregnant.
Methods: Case series study. Patients treated in the National Cancer Institute (Bogotá, Colombia) from August 2007 to July 2013. The epidemiological, clinical, treatment, and complications were reviewed in the medical records. Adherence treatment was recorded. A descriptive data analysis was performed.
Results: The study included 38 patients, of whom 28 already had a cancer diagnosis. The main diagnosis was cervical cancer. The median gestational age at the end of pregnancy was 35 weeks (interquartile range 12 weeks). The main route was vaginal birth (60%), followed by caesarean section (40%). Treatment had to be suspended in 55.5% of cases, 38.9% had changes, and the therapeutic dose was modified in 5.6%. The complications presented during pregnancy were preterm birth, abortions, bleeding, stillbirths, oligohydramnios, and anaemia. A description is presented of the cases of patients who were diagnosed with neoplastic disease during their pregnancy. Adherence to treatment was good in 26 patients and not good in 8 cases.
Conclusions: The patient with cancer and pregnancy represents a diagnostic and therapeutic challenge to the obstetrician and the oncology group. Counselling on contraception and sexual and reproductive health should be emphasised.
Author Biographies
Jesús Acosta, Instituto Nacional de Cancerología
Grupo de Ginecología Oncológica, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia
Oscar Serrano, Instituto Nacional de Cancerología
Grupo de Ginecología Oncológica, Instituto Nacional de Cancerología, Posgrado de Ginecología Oncológica, Universidad Militar Nueva Granada, Bogotá, D. C., Colombia
Lina Trujillo, Instituto Nacional de Cancerología
Grupo de Ginecología Oncológica, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia
David Morales, Instituto Nacional de Cancerología
Grupo de Ginecología Oncológica, Instituto Nacional de Cancerología,Posgrado de Ginecología Oncológica, Universidad Militar Nueva Granada, Bogotá, D. C., Colombia
David López, Instituto Nacional de Cancerología
Grupo de Investigación Clínica, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia
References
Pavlidis NA. Coexistence of pregnancy and malignancy. Oncologist. 2002;7:279-87.
https://doi.org/10.1634/theoncologist.7-6-573
Van Calsteren K, Amant F. Gynecological cancer during pregnancy.
En: Sheiner E, editor. Bleeding During Pregnancy: A Comprehensive Guide. New York: Springer-Science + Business Media; 2011. p. 77-98.
https://doi.org/10.1007/978-1-4419-9810-1
Rendall M, Couet C, Lappegard T, Robert-Bobée I, Rønsen M, Smallwood S. First births by age and education in Britain, Franceand Norway. Popul Trends. 2005:27-34.
Van Calsteren K, Heyns L, De Smet F, Van Eycken L, Gziri MM, Van Gemert W, et al. Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes. J Clin Oncol. 2010;28:683-9.
https://doi.org/10.1200/JCO.2009.23.2801
Matthews TJ, Hamilton BE. Delayed childbearing: more women are having their first child later in life. NCHS Data Brief. 2009:1-8.
https://doi.org/10.1037/e665262010-001
Antonelli NM, Dotters DJ, Katz VL, Kuller JA. Cancer in pregnancy: a review of the literature. Part I-II. Obstet Gynecol Surv. 1996;51:125-42.
https://doi.org/10.1097/00006254-199602000-00022
Karunaratne K. Preface: Issue 30.4. Best Pract Res Clin Obstet Gynaecol. 2016;33:1.
https://doi.org/10.1016/j.bpobgyn.2015.10.014
Morice P, Uzan C, Uzan S. Cancer in pregnancy: a challenging conflict of interest. Lancet. 2012;379:495-6.
https://doi.org/10.1016/S0140-6736(11)61814-X
Amant F, Han SN, Gziri MM, Dekrem J, Van Calsteren K. Chemotherapy during pregnancy. Curr Opin Oncol. 2012;24:580-6.
https://doi.org/10.1097/CCO.0b013e328354e754
Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ. Cancer statistics 2003. CA Cancer J Clin. 2003;53:5-26.
https://doi.org/10.3322/canjclin.53.1.5
Corredor Sanchez E, Castillo M. Cáncer en mujeres embarazadas y su extensión a la unidad fetoplacentaria. Rev Colomb Obstet Ginecol. 2007;58:232-6.
Torres F, Prada N. Cáncer de mama durante el embarazo. Rev Colomb Cir. 2011;26:285-92.
Registro institucional de cáncer INC Colombia. Casos nuevos de cáncer por sexo, según grupos de edad. Bogotá D. C: INC; 2011.
GLOBOCAN 2012. Lyon, IARC [consultado 5 Sep 2016]. Disponible en: http://globocan.iarc.fr/Pages/fact_sheets_population.aspx
Niemasik EE, Letourneau J, Dohan D, Katz A, Melisko M, Rugo H, et al. Patient perceptions of reproductive health counseling at the time of cancer diagnosis: a qualitative study of female California cancer survivors. J Cancer Surviv. 2012;6:324-32.
https://doi.org/10.1007/s11764-012-0227-9
Hoellen F, Reibke R, Hornemann K, Thill M, Luedders DW, Kelling K, et al. Cancer in pregnancy. Part I: basic diagnostic and therapeutic principles and treatment of gynecological malignancies. Arch Gynecol Obstet. 2012;285:195-205.
https://doi.org/10.1007/s00404-011-2058-8
Han SN, Lotgerink A, Gziri MM, Van Calsteren K, Hanssens M, Amant F. Physiologic variations of serum tumor markers in gynecological malignancies during pregnancy: a systematic review. BMC Med. 2012;10:86.
https://doi.org/10.1186/1741-7015-10-86
Sklar CA, Mertens AC, Mitby P, Whitton J, Stovall M, Kasper C, et al. Premature menopause in survivors of childhood cancer: a report from the childhood cancer survivor study. J Natl Cancer Inst. 2006;98:890-6.
https://doi.org/10.1093/jnci/djj243
Barton SE, Najita JS, Ginsburg ES, Leisenring WM, Stovall M, Weathers RE, et al. Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort. Lancet Oncol. 2013;14:873-81,
https://doi.org/10.1016/S1470-2045(13)70251-1
Teh WT, Stern C, Chander S, Hickey M. The Impact of Uterine Radiation on Subsequent Fertility and Pregnancy Outcomes. Bio- Med Research International. 2014. Volume, Article ID 482968, 8 pages.
https://doi.org/10.1155/2014/482968
Amant F, Han S. Management of cancer in pregnancy. Best Practice & Research Clinical Obstetrics and Gynaecology. 2015:1e13.
Delanian S, Lefaix JL. The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway. Radiother Oncol. 2004;73:119-31.
https://doi.org/10.1016/j.radonc.2004.08.021
Luis SA, Christie DR, Kaminski A, Kenny L, Peres MH. Pregnancy and radiotherapy: management options for minimising risk, case series and comprehensive literature review. J Med Imaging Radiat Oncol. 2009;53:559-68.
https://doi.org/10.1111/j.1754-9485.2009.02124.x
Amant F, Van Calsteren K, Halaska MJ, Gziri MM, Hui W, Lagae L, et al. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study. Lancet Oncol. 2012;13:256-64.
https://doi.org/10.1016/S1470-2045(11)70363-1
Cardonick E, Iacobucci A. Use of chemotherapy during human pregnancy. Lancet Oncol. 2004;5:283-91.
https://doi.org/10.1016/S1470-2045(04)01466-4
Van Calsteren K, Verbesselt R, Devlieger R, De Catte L, Chai DC, Van Bree R, et al. Transplacental transfer of paclitaxel, docetaxel, carboplatin, and Trastuzumab in a baboon model. Int J Gynecol Cancer. 2010;20:1456-64.
Van Calsteren K, Verbesselt R, Beijnen J, Devlieger R, De CatteL, Chai DC, et al. Transplacental transfer of anthracyclines, vinblastine, and 4-hydroxycyclophosphamide in a baboon model. Gynecol Oncol. 2010;119:594-600.
https://doi.org/10.1016/j.ygyno.2010.08.019
Peccatori FA, Azim HA Jr, Orecchia R, Hoekstra HJ, Pavlidis N, Kesic V, et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24 suppl. 6:vi160-70.
https://doi.org/10.1093/annonc/mdt199
Stensheim H, Møller B, van Dijk T, Fosså SD. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry- based cohort study. J Clin Oncol. 2009;27:45-51.
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