HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by SOOD, A. K. Articles by NIEBYL, J. Search for Related Content PubMed PubMed Citation Articles by SOOD, A. K. Articles by NIEBYL, J.

Cervical Cancer Diagnosed Shortly After Pregnancy: Prognostic Variables and Delivery Routes

From the Divisions of Gynecologic Oncology and Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Radiation Oncology, and Pharmacology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Address reprint requests to: Anil K. Sood, MD Division of Gynecologic Oncology Department of Obstetrics and Gynecology 200 Hawkins Drive, 4630 JCP Iowa City, IA 52242 E-mail: anil-sood{at}uiowa.edu

Objective: To compare the prognoses of women diagnosed with cervical cancer during pregnancy with the prognoses of those diagnosed within 6 months after delivery and to assess the effect of vaginal delivery on recurrence risk and prognosis.

Methods: A matched case-control study of women with cervical cancer diagnosed during pregnancy or within 6 months of delivery was performed. Fifty-six women had cervical cancer diagnosed during pregnancy and 27 within 6 months after delivery. Controls (cervical cancer diagnosed at least 5 years since last delivery) were matched one-to-one with cases based on age, histology, stage, treatment, and time of treatment.

Results: Among postpartum women, four had stage IA disease, 15 had stage IB1 or IB2, and eight had stage IIA or higher disease. Eleven had radical hysterectomies and 14 had radiation therapy. Two with stage IA1 disease were treated with vaginal hysterectomies. One of seven patients who had cesareans developed a local and distant recurrence. In contrast, ten of 17 (59%) who delivered vaginally developed recurrences (P = .04). In multivariate analysis, vaginal delivery was the most significant predictor of recurrence (odds ratio [OR] 6.91; 95% confidence interval [CI] 1.45, 32.8), followed by high stage (OR 4.66; 95% CI 1.05, 20.8). The survival for patients diagnosed in the postpartum period was significantly worse than for controls.

Conclusion: Women diagnosed postpartum had worse survival than those diagnosed during pregnancy and were at significant risk of recurrent disease, particularly if they delivered vaginally. Therefore, pregnant women with cervical cancer should be delivered by cesarean.

This article has been cited by other articles:

				A. NAIR, J. STEGA, J. R. SMITH, and G. DEL PRIORE Uterus Transplant: Evidence and Ethics Ann. N.Y. Acad. Sci., April 1, 2008; 1127(1): 83 - 91. [Abstract] [Full Text] [PDF]

				A. K. Sood Cancer in Surgical Scar: Insights and Clinical Challenges Obstet. Gynecol., August 1, 2007; 110(2): 453 - 454. [Full Text] [PDF]

				G. Neumann, K. L. Rasmussen, and L. K. Petersen Cervical Adenosquamous Carcinoma: Tumor Implantation in an Episiotomy Scar Obstet. Gynecol., August 1, 2007; 110(2): 467 - 469. [Abstract] [Full Text] [PDF]

				L. Sadler and P. Sykes How little is known about cervical cancer in pregnancy? Ann. Onc., March 1, 2005; 16(3): 341 - 343. [Full Text] [PDF]

				N. Germann, C. Haie-Meder, P. Morice, C. Lhomme, P. Duvillard, K. Hacene, and A. Gerbaulet Management and clinical outcomes of pregnant patients with invasive cervical cancer Ann. Onc., March 1, 2005; 16(3): 397 - 402. [Abstract] [Full Text] [PDF]

				J. I. Sorosky Cervical Cancer Complicating Pregnancy: Two Patients With Three Clinical Objectives Obstet. Gynecol., November 1, 2004; 104(5): 1127 - 1128. [Full Text] [PDF]