TY - JOUR
T1 - Cancer in pregnancy: a survey of current clinical practice
AU - Han, Sileny N.
AU - Kesic, Vesna I.
AU - van Calsteren, Kristel
AU - Petkovic, Sladjana
AU - Amant, Frédéric
AU - AUTHOR GROUP
AU - Skrzypczyk, Anna
AU - Hasenburg, Annette
AU - Uzan, Cathérine
AU - Roussy, Gustave
AU - Lok, Christianne
AU - Benedicic, Christoph
AU - Vaitkiene, Daiva
AU - Peccatori, Fedro
AU - Markowska, Janina
AU - Dahl-Steffensen, Karina
AU - Iraki, Maysoon
AU - Halaska, Michael
AU - Fumagalli, Monica
AU - Ottevanger, Nelleke
AU - Pavlidis, Nicholas
AU - Reed, Nicholas
AU - Cottier, Olivier
AU - Zola, Paolo
AU - Panici, Pierluigi Benedetti
AU - Kimmig, Rainer
AU - Fruscio, Robert
AU - Rouzier, Roman
AU - Loibl, Sibylle
AU - Lang, Uwe
AU - Kolawa, Wojciech
PY - 2013
Y1 - 2013
N2 - Objective: To evaluate physicians' attitudes and knowledge regarding the treatment possibilities for patients with cancer in pregnancy. Study design: A 30-item questionnaire was mailed electronically to physicians across Europe, who were potentially involved in care of pregnant patients and/or cancer, using the membership directories of different professional societies. Results: 142 surveys were eligible for analysis. A median of 2 (range 0-100) patients with cancer in pregnancy were treated per center in 2010. The vast majority of respondents (94%) agreed that management of pregnant patients with cancer should be decided by a multidisciplinary team. When cancer is diagnosed in the first or early second trimester of pregnancy, 44% of respondents prefer termination of pregnancy: if the patient wishes to preserve the pregnancy, 77% consider deliberate delay and treatment later in pregnancy. When cancer is diagnosed in the late second or third trimester of pregnancy, 58% prefer preterm delivery in order to start cancer treatment in the postpartum period: 37% would not give chemotherapy or radiotherapy during pregnancy. Treatment during pregnancy with the aim of a term delivery is preferred by 41% of respondents. Univariate logistic regression analysis found a trend that non-academic hospitals prefer termination of pregnancy (odds ratio [OR] = 0.68; 95% CI, 0.28-1.63; P = 0.39), and also no treatment during pregnancy (OR = 0.70; 95% CI, 0.33-1.50; P = 0.36). Conclusion: Termination of pregnancy, delay of maternal treatment and iatrogenic preterm delivery are frequently applied strategies in the management of pregnant cancer patients. These results suggest that current treatment is not in line with recent evidence, and there is room for improvement on the oncologic treatment of pregnant women. Centralization of treatment is needed. (C) 2012 Elsevier Ireland Ltd. All rights reserved
AB - Objective: To evaluate physicians' attitudes and knowledge regarding the treatment possibilities for patients with cancer in pregnancy. Study design: A 30-item questionnaire was mailed electronically to physicians across Europe, who were potentially involved in care of pregnant patients and/or cancer, using the membership directories of different professional societies. Results: 142 surveys were eligible for analysis. A median of 2 (range 0-100) patients with cancer in pregnancy were treated per center in 2010. The vast majority of respondents (94%) agreed that management of pregnant patients with cancer should be decided by a multidisciplinary team. When cancer is diagnosed in the first or early second trimester of pregnancy, 44% of respondents prefer termination of pregnancy: if the patient wishes to preserve the pregnancy, 77% consider deliberate delay and treatment later in pregnancy. When cancer is diagnosed in the late second or third trimester of pregnancy, 58% prefer preterm delivery in order to start cancer treatment in the postpartum period: 37% would not give chemotherapy or radiotherapy during pregnancy. Treatment during pregnancy with the aim of a term delivery is preferred by 41% of respondents. Univariate logistic regression analysis found a trend that non-academic hospitals prefer termination of pregnancy (odds ratio [OR] = 0.68; 95% CI, 0.28-1.63; P = 0.39), and also no treatment during pregnancy (OR = 0.70; 95% CI, 0.33-1.50; P = 0.36). Conclusion: Termination of pregnancy, delay of maternal treatment and iatrogenic preterm delivery are frequently applied strategies in the management of pregnant cancer patients. These results suggest that current treatment is not in line with recent evidence, and there is room for improvement on the oncologic treatment of pregnant women. Centralization of treatment is needed. (C) 2012 Elsevier Ireland Ltd. All rights reserved
U2 - https://doi.org/10.1016/j.ejogrb.2012.10.026
DO - https://doi.org/10.1016/j.ejogrb.2012.10.026
M3 - Article
C2 - 23182070
SN - 0301-2115
VL - 167
SP - 18
EP - 23
JO - European journal of obstetrics, gynecology, and reproductive biology
JF - European journal of obstetrics, gynecology, and reproductive biology
IS - 1
ER -