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Meta-Analysis
. 2009 Nov;127(6):359-65.
doi: 10.1590/s1516-31802009000600008.

Diagnosis and treatment of cervical cancer during pregnancy

Carla Vitola Gonçalves  1 , Geraldo Duarte, Juvenal Soares Dias da Costa, Alessandra Cristina Marcolin, Mônia Steigleder Bianchi, Daison Dias, Luis Cláudio de Velleca e Lima
Affiliations
Meta-Analysis

Diagnosis and treatment of cervical cancer during pregnancy

Carla Vitola Gonçalves et al. Sao Paulo Med J. 2009 Nov.

Abstract
in English, Portuguese

Context and objective: One third of all cervical carcinomas occur during the reproductive period. Cervical carcinoma is the second greatest cause of death due to cancer during this phase. The estimated frequency of cervical cancer during pregnancy is one case for every 1,000 to 5,000 pregnancies. The aim here was to provide information about the difficulties in diagnosing and managing cervical neoplasia during pregnancy.

Materials: A systematic review of the literature was undertaken through the PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO) databases, using the following words: pregnancy, cervical cancer, diagnosis and management.

Results: There was a consensus in the literature regarding diagnosis of cervical carcinoma and management of preneoplastic lesions during pregnancy. However, for management of invasive carcinoma, there was great divergence regarding the gestational age taken as the limit for observation rather than immediate treatment.

Conclusion: All patients with cytological abnormalities should undergo colposcopy, which will indicate and guide biopsy. Conization is reserved for patients with suspected invasion. High-grade lesions should be monitored during pregnancy and reevaluated after delivery. In cases of invasive carcinoma detected up to the 12th week of pregnancy, patient treatment is prioritized. Regarding diagnoses made during the second trimester, fetal pulmonary maturity can be awaited, and the use of chemotherapy to stabilize the disease until the time of delivery appears to be viable.

CONTEXTO E OBJETIVO:: Um terço dos carcinomas de colo ocorrem no período reprodutivo, sendo que esta é a segunda causa de morte por câncer nessa fase. A freqüência estimada do carcinoma de colo uterino na gravidez é de um caso para cada 1.000 a 5.000 gestações. O objetivo foi informar sobre as dificuldades frente ao diagnóstico e manejo da neoplasia cervical durante a gravidez.

MATERIAIS E MÉTODOS:: Revisão sistemática da literatura foi realizada no PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO), usando as seguintes palavras: gestação, câncer cervical, diagnóstico e manejo.

RESULTADOS:: A literatura apresenta consenso quanto ao diagnóstico do carcinoma cervical e a conduta das lesões pré-neoplásicas durante a gestação. No manejo do carcinoma invasor há grande divergência quanto à idade gestacional considerada como limite para a adoção da observação em vez do tratamento imediato.

CONCLUSÃO:: Toda paciente com citologia alterada deve realizar colposcopia, a qual indicará e a biópsia. A conização é reservada para pacientes com suspeita de invasão. As lesões de alto grau devem ser acompanhadas durante a gestação e reavaliadas após o parto. Em casos de carcinoma invasor em gestantes com até 12 semanas o tratamento da paciente é priorizado. Nos diagnósticos ocorridos no segundo trimestre, pode-se aguardar a maturidade pulmonar fetal e o uso da quimioterapia para estabilizar a doença até o momento do parto parece ser viável.

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Conflict of interest statement

Conflict of interest: None

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References

    1. Jacobs IA, Chang CK, Salti GI. Coexistence of pregnancy and cancer. Am Surg. 2004;70(11):1025–1029. - PubMed
    1. Simcock B, Shafi M. Invasive cancer of the cervix. Obstetrics, Gynaecology and Reproductive Medicine. 2007;17(6):181–187. http://www.obstetrics-gynaecology-journal.com/article/S1751-7214(07)0008... Accessed in 2009 (Nov 25)
    1. Lishner M. Cancer in pregnancy. Ann Oncol. 2003;14(Suppl 3):iii31–iii36. - PubMed
    1. Pavlidis NA. Coexistence of pregnancy and malignancy. Oncologist. 2002;7(4):279–287. - PubMed
    1. Traen K, Svane D, Kryger-Baggesen N, Bertelsen K, Mogensen O. Stage Ib cervical cancer during pregnancy: planned delay in treatment--case report. Eur J Gynaecol Oncol. 2006;27(6):615–617. - PubMed

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