Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 1/2012

01-01-2012 | Gynecologic Oncology

Cancer in pregnancy. Part I: basic diagnostic and therapeutic principles and treatment of gynecological malignancies

Authors: Friederike Hoellen, Roland Reibke, Katrin Hornemann, Marc Thill, Doerte W. Luedders, Katharina Kelling, Amadeus Hornemann, Michael K. Bohlmann

Published in: Archives of Gynecology and Obstetrics | Issue 1/2012

Login to get access

Abstract

Purpose

Cancer in pregnancy is a rare circumstance. However, the coincidence of pregnancy and malignancy is supposed to increase due to a general tendency of postponing childbearing to older age. To date, clinical guidelines are scarce and experience regarding therapeutic management is limited to case reports.

Methods

This review focuses on general diagnostic and therapeutic principles including systemic therapy for malignancies in pregnancy.

Results

In part I, we report on diagnosis and therapy of gynecological tumors.

Conclusion

The diagnosis of gestational cancer faces both oncologist and obstetrician to the dilemma of applying appropriate diagnostic techniques and adequate local and systemic therapy to an expectant mother without harming the fetus.
Literature
1.
Azim HA Jr, Azim H, Peccatori FA (2010) Treatment of cancer during pregnancy with monoclonal antibodies: a real challenge. Expert Rev Clin Immunol 6(6):821–826PubMedCrossRef
2.
Surbone A, Peccatori F, Pavlidis N (2008) Why is the topic of cancer and pregnancy so important? Why and how to read this book. Recent Results Cancer Res 178:1–2PubMedCrossRef
3.
4.
5.
Pentheroudakis G et al (2010) Cancer, fertility and pregnancy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v266–v273PubMedCrossRef
6.
Sarandakou A, Protonotariou E, Rizos D (2007) Tumor markers in biological fluids associated with pregnancy. Crit Rev Clin Lab Sci 44(2):151–178PubMedCrossRef
7.
Patel SJ et al (2007) Imaging the pregnant patient for nonobstetric conditions: algorithms and radiation dose considerations. Radiographics 27(6):1705–1722PubMedCrossRef
8.
Luis SA et al (2009) Pregnancy and radiotherapy: management options for minimising risk, case series and comprehensive literature review. J Med Imaging Radiat Oncol 53(6):559–568PubMedCrossRef
9.
Azim HA Jr, Peccatori FA, Pavlidis N (2010) Treatment of the pregnant mother with cancer: a systematic review on the use of cytotoxic, endocrine, targeted agents and immunotherapy during pregnancy. Part I: solid tumors. Cancer Treat Rev 36(2):101–109PubMedCrossRef
10.
Doll DC, Ringenberg QS, Yarbro JW (1989) Antineoplastic agents and pregnancy. Semin Oncol 16(5):337–346PubMed
11.
Rizack T et al (2009) Management of hematological malignancies during pregnancy. Am J Hematol 84(12):830–841PubMedCrossRef
12.
13.
Loibl S et al (2006) Breast carcinoma during pregnancy. International recommendations from an expert meeting. Cancer 106(2):237–246PubMedCrossRef
14.
Pereg D, Koren G, Lishner M (2007) The treatment of Hodgkin’s and non-Hodgkin’s lymphoma in pregnancy. Haematologica 92(9):1230–1237PubMedCrossRef
15.
Azim HA Jr, Peccatori FA, Pavlidis N (2010) Lung cancer in the pregnant woman: to treat or not to treat, that is the question. Lung Cancer 67(3):251–256PubMedCrossRef
16.
Abellar RG et al (2009) Effects of chemotherapy during pregnancy on the placenta. Pediatr Dev Pathol 12(1):35–41PubMedCrossRef
17.
Van Calsteren K et al (2010) Pharmacokinetics of chemotherapeutic agents in pregnancy: a preclinical and clinical study. Acta Obstet Gynecol Scand 89(10):1338–1345PubMedCrossRef
18.
Schönborn I (2009) Malignant diseases in pregnancy Gynakol Geburtsmed Gynakol. Endokrinol 5(2):114–125
19.
Germann N, Goffinet F, Goldwasser F (2004) Anthracyclines during pregnancy: embryo-fetal outcome in 160 patients. Ann Oncol 15(1):146–150PubMedCrossRef
20.
Grohard P et al (1989) Transplacental passage of doxorubicin. J Gynecol Obstet Biol Reprod (Paris) 18(5):595–600
21.
Mir O et al (2008) Chemotherapy for breast cancer during pregnancy: is epirubicin safe? Ann Oncol 19(10):1814–1815PubMedCrossRef
22.
Espie M, Cuvier C (1998) Treating breast cancer during pregnancy. What can be taken safely? Drug Saf 18(2):135–142PubMedCrossRef
23.
24.
Serkies K, Wegrzynowicz E, and Jassem E (2011) Paclitaxel and cisplatin chemotherapy for ovarian cancer during pregnancy: case report and review of the literature. Arch Gynecol Obstet
25.
Hahn KM et al (2006) Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer 107(6):1219–1226PubMedCrossRef
26.
Mir O et al (2008) Emerging therapeutic options for breast cancer chemotherapy during pregnancy. Ann Oncol 19(4):607–613PubMedCrossRef
27.
Pigeau H et al (2005) Management of rectal cancer in pregnant women. Bull Cancer 92(11):953–958PubMed
28.
Enns GM et al (1999) Apparent cyclophosphamide (cytoxan) embryopathy: a distinct phenotype? Am J Med Genet 86(3):237–241PubMedCrossRef
29.
Ghaemmaghami F, Abbasi F, Abadi AG (2009) A favorable maternal and neonatal outcome following chemotherapy with etoposide, bleomycin, and cisplatin for management of grade 3 immature teratoma of the ovary. J Gynecol Oncol 20(4):257–259PubMedCrossRef
30.
Rosen E, Rubowitz A, Ferencz JR (2009) Exposure to verteporfin and bevacizumab therapy for choroidal neovascularization secondary to punctate inner choroidopathy during pregnancy. Eye (Lond) 23(6):1479CrossRef
31.
Wu Z, Huang J, Sadda S (2010) Inadvertent use of bevacizumab to treat choroidal neovascularisation during pregnancy: a case report. Ann Acad Med Singapore 39(2):143–145PubMed
32.
Zambelli A et al (2008) Erlotinib administration for advanced non-small cell lung cancer during the first 2 months of unrecognized pregnancy. Lung Cancer 60(3):455–457PubMedCrossRef
33.
34.
Cleator SJ et al (2009) A 2009 update on the treatment of patients with hormone receptor-positive breast cancer. Clin Breast Cancer 9(Suppl 1):S6–S17PubMedCrossRef
35.
Illidge TM, Hussey M, Godden CW (1996) Malignant hypercalcaemia in pregnancy and antenatal administration of intravenous pamidronate. Clin Oncol (R Coll Radiol) 8(4):257–258CrossRef
36.
Culbert EC, Schfirin BS (2006) Malignant hypercalcemia in pregnancy: effect of pamidronate on uterine contractions. Obstet Gynecol 108(3 Pt 2):789–791PubMedCrossRef
37.
Yaghoobi M, Koren G, Nulman I (2009) Challenges to diagnosing colorectal cancer during pregnancy. Can Fam Physician 55(9):881–885PubMed
38.
39.
Vannucchi G et al (2010) Clinical and molecular features of differentiated thyroid cancer diagnosed during pregnancy. Eur J Endocrinol 162(1):145–151PubMedCrossRef
40.
41.
Merimsky O et al (1999) Management of cancer in pregnancy: a case of Ewing’s sarcoma of the pelvis in the third trimester. Ann Oncol 10(3):345–350PubMedCrossRef
42.
Goncalves CV et al (2009) Diagnosis and treatment of cervical cancer during pregnancy. Sao Paulo Med J 127(6):359–365PubMedCrossRef
43.
Morice P et al (2009) French recommendations on the management of invasive cervical cancer during pregnancy. Int J Gynecol Cancer 19(9):1638–1641PubMedCrossRef
44.
Marret H et al (2010) Guidelines for the management of ovarian cancer during pregnancy. Eur J Obstet Gynecol Reprod Biol 149(1):18–21PubMedCrossRef
45.
Pentheroudakis G, Pavlidis N (2006) Cancer and pregnancy: poena magna, not anymore. Eur J Cancer 42(2):126–140PubMedCrossRef
46.
Sayedur Rahman M et al (2002) Ovarian carcinoma associated with pregnancy. A review of 9 cases. Acta Obstet Gynecol Scand 81(3):260–264PubMed
47.
Zanotti KM, Belinson JL, Kennedy AW (2000) Treatment of gynecologic cancers in pregnancy. Semin Oncol 27(6):686–698PubMed
48.
Dgani R et al (1989) Ovarian carcinoma during pregnancy: a study of 23 cases in Israel between the years 1960 and 1984. Gynecol Oncol 33(3):326–331PubMedCrossRef
49.
Zhao XY et al (2006) Ovarian cancer in pregnancy: a clinicopathologic analysis of 22 cases and review of the literature. Int J Gynecol Cancer 16(1):8–15PubMedCrossRef
50.
Boulay R, Podczaski E (1998) Ovarian cancer complicating pregnancy. Obstet Gynecol Clin North Am 25(2):385–399PubMedCrossRef
51.
52.
Cardonick E, Iacobucci A (2004) Use of chemotherapy during human pregnancy. Lancet Oncol 5(5):283–291PubMedCrossRef
53.
Sood AK, Shahin MS, Sorosky JI (2001) Paclitaxel and platinum chemotherapy for ovarian carcinoma during pregnancy. Gynecol Oncol 83(3):599–600PubMedCrossRef
54.
55.
Vaccarello L et al (1999) Endometrial carcinoma associated with pregnancy: a report of three cases and review of the literature. Gynecol Oncol 74(1):118–122PubMedCrossRef
56.
Schammel DP et al (1998) Endometrial adenocarcinoma associated with intrauterine pregnancy. A report of five cases and a review of the literature. Int J Gynecol Pathol 17(4):327–335PubMedCrossRef
57.
58.
Schneller JA, Nicastri AD (1994) Intrauterine pregnancy coincident with endometrial carcinoma: a case study and review of the literature. Gynecol Oncol 54(1):87–90PubMedCrossRef
59.
Zirkin HJ, Krugliak L, Katz M (1983) Endometrial adenocarcinoma coincident with intrauterine pregnancy. A case report. J Reprod Med 28(9):624–626PubMed
60.
Regan MA, Rosenzweig BA (1993) Vulvar carcinoma in pregnancy: a case report and literature review. Am J Perinatol 10(4):334–335PubMedCrossRef
61.
Heller DS et al (2000) Pregnancy-associated invasive squamous cell carcinoma of the vulva in a 28 year-old, HIV-negative woman. A case report. J Reprod Med 45(8):659–661PubMed
62.
63.
Couvreux-Dif D et al (2003) Cancer of the vulva and pregnancy: two cases and review of the literature. J Gynecol Obstet Biol Reprod (Paris) 32(1):46–50
64.
Gitsch G, van Eijkeren M, Hacker NF (1995) Surgical therapy of vulvar cancer in pregnancy. Gynecol Oncol 56(2):312–315PubMedCrossRef
65.
Creasman WT (2005) Vaginal cancers. Curr Opin Obstet Gynecol 17(1):71–76PubMed
66.
Baruah N, Sangupta S (1973) Primary carcinoma of vagina complicating pregnancy. J Indian Med Assoc 60(12):469–470PubMed
67.
Church E et al (2010) An unusual case of vaginal leiomyosarcoma in pregnancy. J Obstet Gynaecol 30(7):736–737PubMedCrossRef
68.
Collins CG, Barclay DL (1963) Cancer of the vulva, and cancer of the vagina in pregnancy. Clin Obstet Gynecol 30:927–942PubMedCrossRef
69.
Giordano G et al (2010) Primary adenocarcinoma of the rectovaginal septum arising in pregnancy in the absence of endometriosis. Eur J Gynaecol Oncol 31(2):211–213PubMed
70.
Lutz MH et al (1977) Genital malignancy in pregnancy. Am J Obstet Gynecol 129(5):536–542PubMed
71.
72.
Steed HL et al (2002) Invasive squamous cell carcinoma of the vagina during pregnancy. Obstet Gynecol 100(5 Pt 2):1105–1108PubMedCrossRef
73.
Roth GLU (2004) Vaginal cancer during pregnancy. Gynäkologe 37:514–518
Metadata
Title
Cancer in pregnancy. Part I: basic diagnostic and therapeutic principles and treatment of gynecological malignancies
Authors
Friederike Hoellen
Roland Reibke
Katrin Hornemann
Marc Thill
Doerte W. Luedders
Katharina Kelling
Amadeus Hornemann
Michael K. Bohlmann
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 1/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-011-2058-8

Other articles of this Issue 1/2012

Archives of Gynecology and Obstetrics 1/2012 Go to the issue

Maternal-Fetal Medicine

Sinus venous thrombosis: a differential diagnosis of postpartum headache

General Gynecology

Langerhans cell histiocytosis of the female genital tract: a literature review with additional three case studies in China

Materno-Fetal Medicine

Combination of biochemical markers in predicting pre-term delivery

Gynecologic Oncology

Diagnosis and treatment options of vulvar cancer: a review

Reproductive Medicine

Cervical gland area: a new sonographic marker in predicting preterm delivery

Materno-Fetal Medicine

PAPP-A levels of late pregnancy in preeclampsia and HELLP syndrome